When assessing the stability and laxity of the shoulder, there is something called a sulcus sign. It is a noticeable divot between the top and bottom of the shoulder.
Between the AC joint and the humeral head.
Another lighter example:
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And here is a more extreme:
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It’s important to recognize the ease with which this happens. A simple tug of the shoulder downwards.
As you can surmise, the idea is the more easily the shoulder can be basically pulled out of the socket, the less stable it is. But the rub…
61% of professional pitchers have been found to have this (47% positional players), with 89% of those having it in both arms. Indicating a solid argument it’s genetic; not developmental. (Also indicates you don’t have to have this trait to be a professional.)
When you’re trying to get your arm to do something like this:
You don’t want it to be too stable. You want some laxity. Some instability. If you’re a linebacker looking to hit someone, to have a robust body when hitting the ground over and over, tackle people with outstretched arms, then you want a damn stable shoulder. But when you’re trying to whip your arm back so you can throw harder, some extra range of motion can really help.
With 61% of professional pitchers having a positive sulcus sign, we’re seeing some Darwinism. In other words, pitchers are inherently flexible people. Inherently unstable. At least when it comes to the joint. When it comes to injury prevention -paramount with this population- you tend to not need to work on joint flexibility much. There can certainly be instances (rehab / posterior capsule stiffness are common) where specific stretches are required, but shoulder joint laxity is something these people usually already have, and already work on everytime they throw a ball.
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Deadlifting
Here is a heavy ass deadlift:
Do you see it? This?
A deadlift pulls the ever loving expletive expletive expletive out of the shoulder downwards. The weight is attempting to pull the shoulder out of the socket. Should we really be doing this exercise in a population which already can do this so easily? Do we want to make an inherently unstable shoulder less stable?
Some love the deadlift so much one wonders if the choice came between picking a particular woman to lay next to them on their deathbed or a barbell, if it’s even a contemplation (the barbell). They’re probably thinking “39% of pitchers don’t have a positive sulcus sign, they can still deadlift.”
But baseball players are a population who spends their days violently pulling their arms DOWN. There has a been a misunderstanding baseball players are overhead athletes so they don’t need any more overhead work. Many don’t get their arms above their head. This elbow doesn’t even reach the ear!
Which is why so many with a throwing history have a resting low shoulder.
Muscular flexibility may very well need to be worked on, but in a getting the arm UP kind of manner.
When you spend so much time pulling your arm down, baseball player or everyday person, you probably want to spend some time pushing your arm up to offset that, and think about avoiding extra downward motion.
“But what about strengthening the arm? Couldn’t it help to deadlift to strengthen that instability?”
1) Promoting a movement is promoting a movement. Do a movement a ton and you don’t get better at avoiding that movement!
2) Look at how big and strong the deadlifter above is. Bigger and stronger than any pitcher will be. You can still see the divot where his arm is being pulled out.
3) If you’re in season where it takes 5-7 days to recover from a pitching start, when are you going to deadlift? By the time your rotator cuff is fully recovered, you’re pitching again. Do we really want to throw in a day in the middle where the cuff gets beat up from having to prevent this from happening?
Supraspinatus in red.
It’s an awful lot to ask of guys this little-
4) Why not strengthen the shoulder without doing that to the arm?
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Chris
August 29, 2017
Hi, interesting thought. Wouldnt the activation of the upper traps in a non-maximal dl (the photo shows an extremely heavy deadlift, maybe a 3-1RM) actually protect and strengthen the very stability we need? Of course overhead work is fine or even more important, agreed, but Im just talking about the benefits and safety of a submaximal dl.
b-reddy
August 29, 2017
Hey Chris,
One reason for showing the sulcus sign videos was to illustrate how easily the arm can be pulled out of the socket. If we’re talking a four hundred pound deadlifter, even at 75%, 300 pounds is a lot more force on that arm than what’s being done in a sulcus sign test. It’s hard to overstate how easily the shoulder can be distracted.
Plus, the upper traps can be worked in other ways. Overhead work being one example. (The upper traps are also not adding any stability here. They don’t attach to the humeral head. Perhaps you meant the supraspinatus?)
The main thing I debate here is there is some inherent benefit of deadlifting that can’t be achieved through other means. Besides time management -you can hit a lot of muscles in less time with deadlifting compared to breaking them out into more exercises- I’m not aware of any. Frankly, I believe this to be a primary reason so many have fallen in love with the power lifts, and the olympic lifts. The idea one can do a e.g. 30 minute workout and hit their “minimum effective dose.”
But there has to be tradeoffs to that. Namely, if you’re hitting everything in less time, then the intensity of what you’re doing has to be greater. One way or another, that means greater injury risk. It also means longer recovery time. Something else athletes should be mindful of.
If you only do a deadlift submaximally, well, then you have to hit those muscle groups in a more intense manner anyways. Otherwise there won’t be any training effect. (By intensity here, I mean for a given rep range. One can get stronger / more muscular working at 20 reps, but besides newbies, that 20 reps needs to be hard.)
Chris
August 30, 2017
Thanks for your reply.
Ok, generally about the pros and cons of deadlifts. Well, as always: it depends.
– I think the reason the DL is harder is not because its consciously trained harder than other lifts in order to save time (you dont take 6RM @10RPE every time when doing 6 reps of DL while you go for 6@7 when doing rows), but because the exercise itself is harder: it involves the most muscle mass of the strongest muscles of any exercise. So I agree that recovery is an issue.
– With “submaximally” I meant < 1RM. Theres less injury risk at sets of 4s, 5s, 6s – I guess the photo shows a 1-3RM.
– Now back to the reasons for a DL (or not). I dont think athletes train the deadlift to save time. It shares the same pros and cons of any complex barbell exercise – only a bit more extreme than others. For bodybuilders, the CDL is not a good idea because it is not intense enough (!) for a lot of muscles involved, because some of them are only isometrically trained or over an arbitrary ROM (given by the plate diameter) and because there is no eccentric – all that with a high CNS burden. Menno Henselmans gives an excellent description of principles of exercise selection (for hypertrophy) and a discussion about the DL here: www[dot]simplyshredded[dot]com/7-principles-of-exercise-selection.html
Now, for others, the CDL may be a good idea exactly for the same reasons: It involves the most muscle mass that challenges the CNS for high loads, in a functional pattern (bodybuilders care less about intermuscular coordination). For example, Rippetoe has a different selection criteria for an exercise: "1. The most muscle mass is used 2. over the longest effective ROM 3. so that the heaviest weights can be used 4. to get stronger."
So imo its highly dependend on the individual, his/her abilities and goals. Athlete (which sport? which level? which time of season?…) vs average resistance training novice vs rehab patient.
b-reddy
September 1, 2017
-As far as challenging the CNS, athletes largely get that in their sport training. The purpose of weight-training for athletes is body composition reasons. “If it looks right, it flies right.” Resistance training is secondary to the sport. This is why in a knowledgeable program is will be done after the sport work e.g. a sprinter lifts after sprinting. You can make an argument athletes want to pick low CNS exercises, to leave more in the tank for sport training.
(There are many who believe in using weight training to simulate the sport. Such as speed squats. This is misguided though as nothing in a weight-room is going to approximate the speed -and thus nervous system requirements- of a dynamic sport. You weight train to have muscles, you sport train to practice using those muscles.)
-Rippetoe did need shoulder surgery…but speaking of him, another thing pitchers should avoid is back squatting. Can irritate the hell out of the anterior shoulder, one of the last places pitchers want to be putting in a vulnerable position.
-I’m not debating whether deadlifting can be beneficial. One can make an argument it’s beneficial for virtually any population. Furthermore, I’m not sure anyone debates deadlifting has a higher risk of injury than most exercises. In general, whether that’s because it’s not often taught properly, it puts the spine in a more vulnerable position than most exercises, it doesn’t matter. The risk is there. (Specifically with pitchers though, you can’t avoid the risk of shoulder distraction.)
When training non-powerlifters, there is no need for deadlifting. It’s an option. But there are many options. The general point here is do the benefits of deadlifting outweigh the risks, and can we get the benefits of deadlifting through other exercises. For example, in a pitcher, if one wants to do a loaded hip hinge, why not use a safety squat bar and do a good morning? Are we really missing anything with that? Same thing for barbell squatting. If we use a safety squat bar, do the benefits of squatting disappear? No, but the risk to the shoulder joint does.
Another easy way to end the deadlift debate is look at world class athletes training programs. You’re not going to see many videos of them heavily deadlifting. Sure, you might see some, but by not seeing others then the *need* for it has disappeared. What isn’t debated is a e.g. pitcher needs to pitch. Thus, every other thing that pitcher does, has to account for that top need. Deadlifting, and for that matter conventional bench pressing, squatting, olympic lifts, all do not account for the anatomical differences of a pitcher. Nor are any of them necessary to be a great one. So why bother say, bench pressing when we can use dumbbells?
You’ve already shown this with your bodybuilder example. Bodybuilders do not need to pick exercises which allow the most weight to be used to achieve their goal, and these are the people most interested in muscle mass accretion.
Chris
September 1, 2017
I think were shifting quite a lot between “pitchers” and “athletes” and “gen pop”. So probably this is one reason of misunderstanding. Keeping this in mind…
– Im completely fine with pitchers not deadlifting if deadlifts aggravate or cause shoulder problems. Im not convinced that in submaximal lifts there is always a risk of sulcus sign-like events as shown in the photo – Id need more evidence than an extreme 1RM DL in one person for that.
– I dont agree that generally, DL have a high injury rate – injuries are extremely rare in resistance training compared to a lot of sports. Quite the contrary, resistance training is very safe and protects from (other sports) injuries. As with car driving, of course you need to know how to do it – a good morning can equally crush the annular fibers if done wrong – shear forces are shear forces. “The risk is there” doesnt convince me at all in the presence of such favorable statistics we have for resistance training. And, mind you, resistance training being performed often pretty sillily, not under good supervision of a coach.
– I also dont agree with the only goal of resistance training being hypertrophy, as other goals are strength, coordination (those two is what I meant with CNS), work capacity, mobility.
– Quite a lot of disagreeing, so the next one is: I agree with the safety bar as a great tool for those who have problems with an ordinary barbell. As well as other changes from a powerlifting derived training program: dumbbell use, push-ups or dips instead of benching, different body composition than PL in the open weight class… Im all for individualizing a program for the needs of the trainee.
b-reddy
September 3, 2017
-The deadlift photo is from a video linked in the post. (https://www.youtube.com/watch?v=4EEGp-66TuI) It’s an 8 rep max video. It is submax if the definition is not being a 1 rep max.
-I didn’t say deadlifts have a high absolute injury rate. I said it has a higher injury risk than other exercises. If you had to bet which exercise someone got hurt on, and you were picking between deadlifts, walking lunges, single leg RDL, db bench pressing, [name a lot of exercises] deadlifting is where Vegas would have its money.
Few have access to one on one training from a good coach. Even in a D-1 weight-room, the strength coach can’t watch all the lifts. Even with one on one coaching, I’m not sure how you could say the injury risk from a deadlift is no worse than the risk of say, a single leg RDL, or virtually all other exercises which work the same muscles. Coaching can be great, but coaching can’t prevent faulty reps 100% of the time. So for those times form isn’t perfect, we want to mitigate risk the best we can. A faulty single leg RDL isn’t going to risk ruining a spine like a conventional deadlift can. (Nor does a rep have to be faulty technique wise to cause injury.)
If one wants to pick their exercises based on absolute injury risk in relation to sports, then alright. I don’t think that makes sense. Rather, I’d pick exercises based on their injury risk relative to one another. That is, I don’t pick a deadlift based on whether it’s safer than playing football or soccer. I pick deadlifting in relation to other exercises which can work the same muscles / movement.
Perhaps you pick exercises differently. Such as which exercises get the most bang for the buck, or work the most muscle, or most work a certain muscle, hit the CNS the hardest, etc. I’m working backwards from which exercises have the most risk to benefit, then go from there. The first goal is do no harm (or at worst do the least harm) then other goals come in. This is medicine’s first goal; I have trouble seeing coaching should be different.
-Mobility, coordination, work capacity, can all be achieved without resistance training. (Which means they be achieved without deadlifting.)
I mean, the average athlete does not say “I’m hitting the weights today to work on my coordination for throwing a baseball.” Or “I’m resistance training this week to help my mobility for basketball.” “Or I’m lifting instead of running today to help my work capacity for a marathon.” Sure, those things can be worked on, or can be nice side effects, but they are not the primary purpose of weight training for athletes.
Chris
September 4, 2017
– A single leg RDL is fine – however of course it doesnt accomplish the same thing as a bilateral CDL – because stabilization is the limiting factor for all-out muscle activation of the prime movers. Can be positive, or negative, according on the goals. Likewise it doesnt work the erector spinae as much – but more unilateral q. lumborum or r. obliques. Again, that can be an advantage or an disadvantage. Simply do both versions! In the article by Henselmans that I linked above, he gives a good example for dumbbell pressing.
– Mobility is nicely preserved and enhanced with resistance training because it actually can lengthen muscles via eccentric lengthening (under load). Something that static/unloaded stretching can not. Not the primary goal, but nice to have alongside.
– With “coordination” I didnt mean sports-specific coordination, but something like knowing how to set your back against resistance. So, general movement skills that need both coordination and strength that also can help athletes minimize risks.
I understand that you have a certain priority, and thats highly stressed injury avoidance. Howevern, its just hard to decide which priority system is best, because we dont have that fine data sets (effectiveness vs injury vs time vs…), let alone longitudinal training studies comparing different programming styles. So its very difficult for you – or me or anyone – to claim with proof that “this has the best risk-benefit”: I think youre overestimating the risks (due to your background and clients), you think Im underestimating them (due to my not having a physiotherapist background).
Well, maybe the truth lies in the middle.
Thank you for a nice discussion (so far)!
b-reddy
September 5, 2017
Thank you for the discussion as well. Appreciate the exchange of ideas!