Apr 05, 2023
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Dr. Yoni Rosenblatt: This one is so good. This was a conversation with Eric Cressey, one of the foremost strength and conditioning coaches really in the country, has risen to prominence when he started CSP, that's both in Massachusetts and Florida. And now, he is essentially Director performance of the New York Yankees. He spent a bunch of time just walking through his evaluation, also highlighting what he's learned through his career, both business and clinical sides. And I learned a tremendous amount just talking with him. So generous with his time, really made for an eye-opening conversation, what it's like to be in the big leagues. And also to be in the private sector. So I really hope you guys enjoy it. Please, share your feedback, share the conversation with anyone who might enjoy some high-level clinical and also also business takeaways. So please spread it around, give us a nice review wherever you're listening to your podcast. As always, if you're interested in joining the true sports physical therapy team, shoot me an email yoni, Y-O-N-I@truesportspt.com, or you can always hit us on Instagram @truesportspt. We'd love to educate you, we'd love to have you as part of the team, and I'd love to learn from you, we'd all love to learn from you. So drop us a line and please enjoy this conversation with Eric Cressey.
Dr. Yoni Rosenblatt: Welcome back to the True Sports Physical Therapy Podcast. As always, this is Yoni Rosenblatt, your host. Really excited to have Eric Cressey with us. The man, the myth, the legend. I've known him for a number of years now. And we're gonna dive into all things business and then get into all things clinical specifically. Obviously, when you talk to Eric Cressey, you better talk about strength training for the picture. So what I wanna start with is Eric, as if no one knows you are, tell us who the hell you are and how you've got where you are today.
Eric Cressey: Right. Well, first off, thank you very much for having me. Yeah, I guess, the CliffsNote version, I co-founded Cressey Sports Performance. We started out with a Massachusetts facility back in 2007, and quickly established this baseball niche that developed into something that was more than just high school kids, it became college guys, pro guys. We saw guys from all 30 major league organizations. In 2014, we opened a Florida location and then expanded it in 2019. So we basically have two locations, one in Massachusetts one in Florida. And then at the end of 2019, I joined the New York Yankees as Director of Player health and performance, which is a basic role that oversees strength and conditioning, nutrition and elements of manual therapy. We work in parallel with sports medicine and our performance science department. And on top of that, I do writing, consulting, speaking, a lot of things in that vein. And then I'm a husband and a dad of three daughters.
Dr. Yoni Rosenblatt: Okay, I love it. I am also a husband and a dad of three daughters...
Eric Cressey: Great minds. [laughter]
Dr. Yoni Rosenblatt: So we got that going on... Yeah, great minds. So let me ask you this, how do you juggle those things? How are you the world's best dad and husband and businessman and strength coach?
Eric Cressey: Yeah, I think it's a very much a moving target and something that I've had to work very, very hard to kind of learn to optimize as best as I can. I think it's probably like... Anybody's parenting experience, in some days, you feel like you're way better at it than others. So I think if there's one thing I've learned, it's understanding what things I do well and what I don't do well. If you look at kind of like the classic entrepreneurial initiatives. It talk about the technician, the entrepreneur and the manager. And I tend to be a pretty good technician. I tend to be pretty entrepreneurial. I'm not always the best manager of people, so I'm really fortunate in our Massachusetts facility, my business partner, Pete and John O'Neil, they really take the lead on a lot of that stuff. At CSP Florida, my wife, Anna, and my business partner, Shane, they handle a lot of that stuff. And then in our Yankees role, I've got an amazing major league strength coach in Brett McCabe. And then, Donovan Santas is our Assistant Director of Player Health and Performance, and Donovan's got over 20 years in professional baseball and just a wonderful guy when it comes to leading people, managing systems things like that. In a lot of ways, and I don't necessarily love the term, but it's one that's been thrown out there, you kind of have visionaries and you have integrators.
Eric Cressey: I've been really, really fortunate to have some awesome integrators that have allowed me to kind of nerd out a little bit more, try to be a little bit more visionary, try to see parallels and connections across different disciplines. And so, I think a lot of the success were maybe taking on a high workload has really been a function of just awesome people working behind the scenes to set me up for success. I'm really lucky to have them.
Dr. Yoni Rosenblatt: Did you set out to do this? Did you have any type of vision of what this would look like?
Eric Cressey: Yeah. The baseball niche, no. To be honest, Pete and I joke about when we first opened up, we were training anyone who would help us pay our rent. And then, I think it was probably a year or two into our business, we actually... And to be honest, I don't even remember it. Pete tells me about it often, but we actually had a sit-down meeting with myself, Pete and Tony Gentilcore, who's another one of our co-founders. We're like, "What are we doing? Like this is becoming like all of baseball players, it's gonna be empty once baseball season is going and we've gotta diversify. We're gotta get more athletes in here from different sports and da, da, da, da, da". And apparently, and I don't remember saying it. He reminds me of it, he's like, I was like, "Why don't we just double down on baseball?" And again, apparently, it was a very impactful moment for him. And like I say, on the managerial side of things, on the entrepreneurial side of things, but it just so happened, that was something that we really embraced, we realized it was a very underserved population. And like that, we were in a good position. The right time, right place.
Eric Cressey: And we studied hard, we try to quickly evaluate our results or lack thereof, to see what worked and what didn't. And I think here we are 16 years later. And it's something that's still very much a work in progress. We try to evolve all the time. Like we make our mistakes, we take our licks just like everybody else, but we try to be better with each passing day, and we try to create really, really good synergy across our departments. And one of the things I think that's really vitally important for people to consider is, I'm fortunate. I see it from the major league team side, and I see it from the private sector side. And, excuse me, for the longest time, we had to compete with major league organizations in the private sector. We were, a staff of seven and, we were up against these multi-billion dollar franchises, yet athletes were moving to the middle of nowhere to train with us for an extended period of time.
Eric Cressey: And there was a critical point where I kind of just started to think about like, "Why would they do this?" And it always comes back to, our synergy, how well we were able to communicate with one another, how well we were able to deliver a very personalized experience for our athletes to show that we really cared. And over the course of time, we just tried to build out our staff more and more with a lot of really good growth mindset people that were all collectively focused on, all that matters is the athlete's outcome. Don't design your business model, design your training model, because the training model is what supports the athletes, [chuckle] far more than the business aspect of it. And, have we left some money on the table over the years because of it? Probably. But I do think we've probably had greater adherence from our athletes and greater long term relationships with our clients because of it.
Dr. Yoni Rosenblatt: Today, I mean, I run into your athletes all over. I mean, even in Baltimore. And, but worked with them when I worked with the Israeli national baseball team. They just freaking love you. [chuckle] I mean, they love you. It's really incredible. And when I spent time down in your Florida facility before you blew it out, there was a very clear culture, a Cressey culture that was there. How did you develop that? And how conscious were you to cultivate it?
Eric Cressey: Yeah, I think the secret is that you don't develop it. You let the athletes do it. You set the guardrails, right? It's like bowling with your kids. Like we just put the bumper plates in the... The bumper is in the aisles and gutter has a lot to do... But...
Dr. Yoni Rosenblatt: Bumper plates, I like that.
Eric Cressey: It's funny, like, CSP family, that started with an athlete. Like it was a hashtag that he brought up. It just happened over the course of time. Like there were periods, before my wife and I had kids, where we had like four different minor leaguers like staying in our bedrooms at our house. Like we were the Cressey bed and breakfast. So I really think, not to use a hacking expression again, but I think culture is a moving target.
Eric Cressey: I think it's in a good place, but it's a very different culture than it was in say, 2009, 2010. It's had to evolve over the course of time. But yeah, I think it's vitally important to let the athletes drive it. And you just have to be mindful of like, what is and isn't okay. Like what are the direct... Like, you're not gonna walk into our facility. I'm never gonna be okay with F-bombs and F-words like in the music. Like, it's just not okay. That's not something I am. It doesn't matter whether we have athletes that don't mind that kind of music. Like that's something for me personally is not, something that I'm cool with. So you do have to establish some guardrails. But I think for the most part, our athletes have really handled themselves really well and in taking that autonomy.
Dr. Yoni Rosenblatt: What's different about the athlete today, 2023 versus 2007 in mass?
Eric Cressey: Yeah. I think it's representative of a larger, kind of big picture industry discussion. I don't think the athletes are inherently different. I think the situations that govern their behavior are different, right? There's way more distractions, there's more social media, phones are a lot different now than they were in 2007. I think there's a lot more pressure to be really good early, there's definitely way more sports specialization. On that side of things, I think parents have definitely evolved for the worst since then.
Dr. Yoni Rosenblatt: Deposed.
Eric Cressey: There was a lot more of keeping up with the Joneses. I don't think we let kids fail nearly enough. I think our job as coaches is really to give athletes an opportunity to fail safely. Let them fail forward, where there aren't consequences. So that's a big one. And then the other thing, just like speaking specifically to baseball, as a frame of reference, if you were an 88 to 90 left-handed pitcher, when we opened CSP in 2007, you were a top five rounder. It was a done deal, even out of high school. Like you were probably a top two rounder if you were doing out of high school. And there was some period probably 2016, 2017, where we had five free agent lefties throwing 95 who couldn't get jobs in professional baseball.
Dr. Yoni Rosenblatt: It's insane.
Eric Cressey: It was astounding to me. And like some, one of them was like from the University of Buffalo. It's like, in the past, this would've been a guy that like every scout in the country had been racing to see and all that. And the velocity has just surged so much. And I think, you're obviously in the sports medicine world, we realize that we're just, we're playing with a completely different set of rules. When I hear people like ranting and raving and about the injury rates, and even the stuff that's happening like in the NBA with all the workload management, the games are played in at such outrageous speeds that the casual fan just can't appreciate this... I've told this story before, but Buddy Morris has, a guy who's been in the industry for a long time. And Buddy was in the NFL. He left and went to the college setting and he came back to the NFL and I saw him probably 2006 or so at a conference. And he was just like, "Eric, you people can't understand.
Eric Cressey: It's like a car accident on every play in the NFL now". Like, the average career is two years for some of these guys. And, baseball is just, it's like that as well. We know that, basically every mile per hour increase in velocity on average is about a 15 to 20% increase in UCL injury risk, depending on the study you look at. And we saw it front and center, like our Yankees roster last year, we had the highest average fastball velocity in major league history. And we were also for the most of the season, the second oldest roster. So you just, it's an interesting kind of like combination and it's something you have to be really mindful of.
Dr. Yoni Rosenblatt: Yeah. It is crazy. I mean, we have a staff PT, now he's a clinic director who throws 96 miles an hour. Like, how is that possible that that guy walks away from the game throwing 96, totally healthy and gets his doctorate? Like, it's because everyone throws 96. It's really crazy to think about. So, you said you made your mistakes, you took your licks. What's the biggest mistake you made clinically?
Eric Cressey: Yeah, I mean clinically, I think, [chuckle] where to begin. I'll say one is, I always... This is one that actually, really, I think still keeps me up at night. We had a young athlete I won't mention by name. He was a pretty high round draft pick who we kind of took him under his wing. His dad passed away from cancer not long after he was drafted. He dropped everything, moved to Massachusetts, and really became part of our family. And, left-handed pitcher who just could not get lefties out. They saw his curve ball out of his hand. And he always had talent and, basically the play was to learn a slider. And I just, I'll never forget, he went out and he just threw slider after slider after slider that off season.
Eric Cressey: And it was nasty. And he bled his elbow. And his second week of the season and looking back, it was just like, it was completely overlooking both workload and the fact that learning a new pitch is inherently more stressful because it's not optimized, synchronized. And that was probably 2009, 2010 when that happened. And you're a guy who's in low, a high at that point and you miss a year and a half for Tommy John. It's a a massive stunt to your development.
Dr. Yoni Rosenblatt: Sure.
Eric Cressey: And he never made it. And we're still very close to this day. He was at my wedding. Like we text often. He's part of our family for good. And he actually, he's in the fitness industry now. I'm super proud of like what he's become, but he didn't get to the big leagues. And I look back on that and it always motivates me because if I had known then what I know now, he probably would've gone to the big leagues. And I know it because like what we can do with Edgertronic cameras, what we can do with just ball tracking metrics. Like he could have learned that slider in 25% as many pitches.
Dr. Yoni Rosenblatt: Sure.
Eric Cressey: And not only that, I would've had a much better mindset for acute chronic workload, what a standard off-season was, how different in off-season in Massachusetts is compared to what they get when they go to spring training? We've definitely seen examples of guys who go from cold weather to warm weather, and it can be a huge, it can be a big velocity jump in many cases that they get warm weather. It does seem like the workload always spikes 'cause they feel better. I know how to counsel guys better on this stuff now. So like big picture clinically, like that's a sample size of one that, as much as it stinks, and I wish it was a different outcome, it has been a great motivator for me. It's been something that, you never want to not be able to help a guy like that who was completely committed to the process. And I thought we did a great job with his training. And at that point, I just didn't see every element of synergy that I really, I think see now and it's still an evolving model, for sure.
Dr. Yoni Rosenblatt: But also there was so much you couldn't measure. Like how the hell were you supposed to know? And had you had those tools. It speaks to like what we're asking these arms to do with weighted balls and with all the load. But also on the flip side, like on both of our professional levels, it's you're looking to add the latest and greatest in injury prevention, right? And injury mitigation. And so hopefully, those things come along. That is eye-opening and definitely been there. I love that you used it to fuel the next 10 years of your career or, eight years of career so far. So...
Eric Cressey: The second thing I'll say too, it's maybe a little bit of a ride on, it's kind of our current conquest. I think for too long, we've tried to use norms. I think everyone's familiar with like, ASMI's critical instance and a lot of things that they put out back in the day. We know some of the best throwers on the planet are way outside the normative ranges on a lot of those things. And I think for too long, we chased optimal pitching mechanics, and we've gone much more to like an archetype model is that, you can see the difference between a wide and a narrow infra-sternal angle and in the way that they attack things. You're a narrow ISA guys, it's like, it's fine I'm a hip hinge. You're wide ISA guys, it's teach them how to rotate in a narrow hallway.
Eric Cressey: Like you just see some of these cues. And I just, I look back over the years and, it wasn't me directly necessarily coaching these guys. I'm pitching mechanics, but I could have been a better advocate for them with pitching coaches if I understood how to really batch athletes. I think we're seeing more and more resources now where you can say, all right, picture X has this movement screen, has this kind of range of motion, has this, basically infra-sternal angle, that's this archetype. And then also, these are how their fastball profiles look, they throw a slider from this vertical release height and hit the vertical approach angle on this fastball is this. And we now have the data where we can literally match them up perfectly to an existing major leaguer who's having success.
Eric Cressey: And that is so powerful. And that's what we've really done at our facility. We use Theia, which is an awesome markerless biomechanics, set up where you can basically take it on field and get it in really game like, experience without having a rig like, markers all over people. And it's been so cool just to see the data set emerge, and honestly just nerd out on the outliers. See some of these guys that do crazy things, looking at like a guy with anteverted hips, like who just does things completely different than you would expect, but he's known to protect himself from cookie cutter coaching cues over the years. And now we have a basically, a movement awareness and the data to basically like, "You have been right all these years, don't let them change you. What you're doing right now is something you should absolutely embrace". So that's exciting using like these movement models to drive what is the right kind of pitching mechanics for people.
Dr. Yoni Rosenblatt: Yeah. I think that is awesome. So you're speaking to hundreds if not thousands of sports PTs coming on here. So there's some type of understanding but, and clinical acumen. But I do think that these newer ways to bucket these athletes doesn't hit the medical side enough. And so, do me a favor, can you just break down those archetypes and the way you look at it and that's gonna bleed into your eval when a pitcher walks in?
Eric Cressey: Yeah, for sure. I think the first thing we can both agree on, I know you deal with a ton of throwers, both in your clinic and then, obviously, in your experience in being involved in competitive baseball. In general, a lot of the information surrounding baseball development and also baseball rehab, even surgical interventions, to be honest, is very slow to trickle down in the research community. We still see kids that come in with a diagnosis of GERD. It's like, "Guys, if they don't have GERD, I'm more concerned." And, really, more and more of the research is showing that it's actually insufficient external rotation, particularly active external rotation, that's far more concerning. So if you don't have retroversion in your proximal humerus, you're probably not gonna throw a baseball at a high level. I'm always astounded at how often we get that on a note from a doctor or from a physical therapist, and I can tell you honestly, every other week... I actually saw two this week, kids with bum shoulders who had been sleeper stretched till the cows come home as part of rehab. And what had they done? They had taken something that was probably a mild internal impingement from a lack of controlling their external rotation. Instead, they walked in with a bursitis and a more pronounced cuff irritation because they were just beating on the other aspect of their joint.
Eric Cressey: So that's something that we need to be very mindful, is that the new information is just not being disseminated to the people that really need to hear it. And that's why I'm always a big advocate to our athletes, is go to people that have a track record in this, don't just go to the same ortho that recommends labral repairs to every thrower that comes in with a little bit of posterior labral fraying, it's a total normal finding, so we've really worked hard to build up that network, so...
Dr. Yoni Rosenblatt: How do we... So I know you have a network, 'cause I've hit you up when I'm like, "I got a guy in Boise to find, whatever, some PT". How do we get that information down to the clinicians quicker?
Eric Cressey: Yeah, to be honest, I think one thing that's exciting, this is where social media has actually been really good. You have some wonderful physicians and PTs that are putting themselves out there, like I don't know if you know Christopher Camp, who's the Twins team doctor trained in HSS. Chris has done some wonderful research and put a lot of great information about our injury rates and all these different things, Steve Cooley, put stuff out publicly, there's actually a ton of information out there, and you're seeing doctors and our own team, Dr. Chris Ahmad is outstanding, he's got an excellent social media presence, and he's got Frank Alexander, who's kind of his clinic director who does a lot of great stuff for disseminating information. They're really good PTs and MDs that are actually going out there and shouting this stuff from the rooftops.
Eric Cressey: And so, I think that's a very exciting aspect of social media, there's a lot of negativity out there, but if you're a young, enthusiastic clinician and you're excited to go learn, it's definitely out there. Now, that people are very accessible, go to ASMI and literally just stick around after the seminar, I mean, these guys will spend a ton of time with you and talk you through these things 'cause they wanna see the industry get better, I think at the end of the day, again, I'm going on a tangent, like baseball is something I love it's something I did when my grandfather took me and I learned how to read off of baseball cards, and I remember going to my early games in Connecticut when I was four and going to see Bret Saberhagen face Roger Clemens at Fenway Park.
Eric Cressey: These are things that stand in my memory, I wanna leave the game better than I found it, and I think that's true of all the clinicians that I interact with, I think it's true of a lot of the players as well, they're very focused on this being better so fortunately, we have people that are putting themselves out there and trying to be the rising tide that lifts all ships.
Dr. Yoni Rosenblatt: And I think you're a great example that hopping on this opening day, not just hopping on a pod in your hotel room, and we really appreciate it. It's also on the clinicians, all the clinicians here listening, all the clinicians that work with me, like when Cressey mentions this growth mindset, like the information is now there, you just gotta chase it, you gotta be discerning, but you gotta show the want to go get that information and it is totally readily available, something that... I mean, I just got off a phone call yesterday, I was talking to the Mets doctor, and he's classically trained, upper extremity specialist, orthopedic surgeon, he's like, "I don't operate on shoulders in pitchers anymore." I'm like, "What? We're gonna do this whole pod." He's like, "You don't fix shoulders, you fix elbows. You refer shoulders to PTs." So I'm like, "Where the hell did you learn that?" Because 98% of MDs just aren't thinking that way. And what I'd love to see is just more that MD-PT collaboration, and by the way, the strength coach knows more than all of us, so I think... Pulling down those silos is a number one, it sounds like you're doing something really special like that in New York, it's definitely...
Dr. Yoni Rosenblatt: By the way, like to answer my own question to you, I think that's what makes the culture down at Cressey so awesome, or up at Cressey. There just aren't silos. It's really refreshing. So that's my segue to my very first Cressey memory. Okay, you still had that haircut, it was at like 20... By the way, should we have done this earlier, we probably should have taken it down earlier than we did, no?
Eric Cressey: No.
Dr. Yoni Rosenblatt: Your hat... You're good. Okay.
Eric Cressey: You're good.
Dr. Yoni Rosenblatt: Okay, I go down to Florida, I meet Eric Cressey, super nice, shakes my hand, it's like 7:30 in the morning. We talk a little bit about God knows what, and then you look up to me and you're like, "Yoni, I gotta coach now". I'm like, "What? Okay". And you just walk away from me and you just lock in to the athletes that are in front of you, because that's what you freaking love doing, and it was just refreshing to see that you still gave a damn 10, 12 years in, right? So what you did on that day was you walked away from me, you're like, "Hey, I have an eval, I'm gonna go work." I went to your partner Shane Rye down there and spent time with him, but I never got to see what happened when you did that eval and that intake.
Dr. Yoni Rosenblatt: Okay, so that's what I wanted to get to today. So professional baseball pitcher walks in, let's say he's double A, he hears about Cressey on IG, all his buddies say, hey, I go down to Cressey in the off-season, it's October 1st. What does that interaction look like with you?
Eric Cressey: Yeah, for sure. So above all, there's an element of prospect and it takes place beforehand, right? Just wanna sure that they're matched up to the right person on our staff and... Yes, I do the overall majority of the pro athletes, but evaluations, but there are a lot more guys that come in that might see other members of our staff who are a better fit and stuff like that. So, but what it actually comes to the assessment, I've usually got their entire injury history in front of me, but you usually wanna pry just because guys generally tend to under report on that stuff. High school athletes that don't list prescription medications or broken bones in the past and things like that, so I always try to pry a little bit, but really more than anything that initial day is really get to know you, the most important thing is to build some rapport. Let them know that you genuinely care and you're interested in learning a lot more than just a cursory medical history. You wanna dig in on how something may have altered the mechanics after an injury or, "Hey, what are you trying to do this off season, let's talk to go goals", all that stuff.
Eric Cressey: What went well this past season and what didn't. And then from there in the office, we'll go through a collection of postural assessments where everything from static posture, SFMA, cervical screens, shoulder flexion, abduction, ER, where the arms adducted, look at the toe touch, we'll look at a single leg balance. We'll do some manual muscle testing of the cuff. And then once I've got a pretty good feel for all that stuff, we will head back out and actually do some stuff on the tables, where we get a lot of classic, I guess orthopedic range of motion assessments. Measure infrasternal angle, and then get them up to do more dynamic screens things like an overhead lunge walk, overhead squat, pushup test. Look at like a dorsiflexion range motion test. And all those things get logged in our data set. And that's what's really, really key is that the way that that is structured in our cloud, our pitching crew and our hitting crew has full access to it. And that's vitally, vitally important. It's not just, it doesn't go in like a lockbox and no one sees it because we want them to have access to it so that they kind of have a feel for, all right this guy's got a 10 degree loss of extension in his elbow.
Eric Cressey: Like it might impact his ability to stay on the baseball, and throw a really good change up or something like that. We also do a Proteus power test, just to give us an idea of kind like how they profile out from a forced-velocity standpoint. You get guys that are kind of like your classic fascially driven athletes that are really elastic. You'll see some athletes that are more mechanical, more wide ISA, just strong dudes that don't move fast enough. And then you'll see guys that are just plain weak that haven't even bought themselves a seat at the table, so they need to just train. And that's something we try to retest over the course of the off season. They also will do more of like a skill specific meeting.
Eric Cressey: So like they're gonna sit down and they're gonna go over everything with our pitching coaches. They're gonna break down video of their deliveries. They're gonna talk about, their pitch mix, how it all works together, their usage, all these different things. Those are always interesting conversations because there is such a mixed bag of experiences across the 30 professional organizations and certainly across the college realm as well. But the goal is obviously to dig in on how the body moves. We do a lot of test, retest, as part of that just to see if someone has some mild symptoms can we alleviate it. And then also, it's a chance from a really, like a more like skill specific standpoint try to really hone in on how we can absolutely help them to become better baseball players above all else.
Dr. Yoni Rosenblatt: Yeah. No, the only tech I heard you mention is Proteus. Are you using goniometry in this... Because...
Eric Cressey: Yeah, we will. To be honest, I eyeball a lot. Just because I'm a little bit less, our physical therapist will definitely measure, but I can kind of tell you whether it's 30 degrees of internal rotation at a shoulder or 45. So, you can spend all day measuring, but for the most part, my eyeball goniometer is reasonably accurate. We do use a lot of tech. Proteus is certainly part of it. We've done 10-yard start times, we can measure vertical jump. I tend to like Proteus just 'cause it's outside the sagittal plane a little bit more. But we have a ton of tech on the pitching side of things that is tracking it down..
Dr. Yoni Rosenblatt: But that eval...
Eric Cressey: Yeah. I mean well, a lot of guys will throw exit bullpens with us when they do come in at the end of the season. If the timing is right and it kind of works out. But to be honest, you probably need those a little bit less than ever before because video is so accessible. And then all the external metrics are so available for these guys, and many of the times the athletes bring them with them. So you don't have to really search for it nearly as bad as you used to.
Dr. Yoni Rosenblatt: And then you're taking all that data and putting it in what?
Eric Cressey: It just, for us, it goes to the cloud. So we have access to it so we can repeat our evaluations and make sure things are improving in the direction we want, but more importantly it allows our pitching and hitting crews to really kind of build out this archetype of how we want people to be coached. What are the key competencies? What are the goals? And to be honest, this goes hand in hand with Theia Markerless biomechanics stuff. Guys aren't always throwing exit bullpens on that when they arrive in the fall. But they definitely are getting on to Theia, starting in January, so we can get some really good data on that. And you see some pretty crazy stuff. You see some guys with shockingly limited shoulder external rotation who are able to, generate velo with a little bit more lateral trunk tilt, you see athletes who spin the ball at like outrageously high RPMs. Yet they have some of the stiffest wrists that you could possibly imagine.
Eric Cressey: And so, I'm a big believer it's kinda like a Stuart McGill lesson, but he always talked about, "Don't just look for the averages, look for the outliers, figure out why weird things work". And I've always tried to embrace unique, and what makes guys special. So yeah, those are some of the things that I think we've used to, along the objective lines to, to get there.
Dr. Yoni Rosenblatt: Now, are you double... You mentioned this before, how you'll find people with their strengths, actually you mentioned that with you specifically where you'll double down on your strengths, as opposed to trying to kind of fill in the weaknesses. How would you say that relates to your strength and conditioning programming?
Eric Cressey: Yeah, I mean I don't know that you ever want to ignore weaknesses. Like you always wanna bring things up. I think the concern is more like, sometimes you go to attack that weakness and you can create more problems, right? Whether that's actually taking someone and giving them too much motion transiently, that's like the old Greg Rose story about like the chiropractor who adjusts everybody right before the first tee at the charity golf tournament, and they all have their worst round ever and finish up with back pain. You give them motion they can't control. So that's, certainly concerning. And also you never want to be, stretching guys into a bony block, or something like that. Very rarely are you ever gonna get into trouble adding good stiffness to the system, but there are times when you take away what you think is bad stiffness, it might actually be there for a reason.
Eric Cressey: So, treating a bunch of protective tension can sometimes get people in a much worse spot than beforehand. Like, I'll be honest, like we don't really stretch hamstrings ever. And we don't have hamstrings injuries, nearly as high as the industry average. We're actually establishing good stiffness to restore a semblance of posterior pelvic tilt and tone down some protective tension. So it sounds silly to say but yeah, you're adding stiffness to a system that's already stiff so that it moves better.
Dr. Yoni Rosenblatt: Yeah. Yeah. I see this, I mean I definitely see this pictures, but you look at the NFL defensive back I mean, those dudes are so anteriorly tilted, right? And so, like trying to figure out, okay, how do we train around that without robbing them of that? Because that tension just makes them so freaking explosive. It also makes their backs hurt. It also makes their hamstrings blow up. But how do you do that without giving them a three times 30-second hamstring stretch for home, right because...
Eric Cressey: That's the truth. And you can also appreciate that like, there's nothing fundamentally healthy about playing sports at an incredibly high level. Like, there's nothing natural about throwing a baseball, like NFL guys are running into 350-pound dudes, like that's not inherently healthy. Like even just looking at like tennis players, what they go through like 40 weeks of travel, every year. It's just, nobody's really built for that. But they do it because it's their livelihood. They don't do it forever. And I think it's on us to figure out how we can best optimize them during that window of competition.
Dr. Yoni Rosenblatt: Of course, you bring up tennis. You always look for a way to sneak in some type of tennis analogy. Okay, so now within this program, well, you take all that information, then what happens, like nitty-gritty, you go home that night like you just shared with me, "Hey, I'm gonna spend the rest of the night going through hundreds of Yankees data and to put together their program". Are you doing that if you did that eval for this... As a way train?
Eric Cressey: As a good rule of thumb at our facilities, if you evaluate someone, you write their programs, so everybody kinda has their people that they watch over, even though we coach as a collective. Yeah, so if I'm doing the assessments, I'm the one writing the program or I'm the one overseeing the off-season progressions and all of that, and I'm also expected to be the one that's kinda doing the check-ins just on how things are going and whether it's on-the-fly evaluations or in some cases, it's notifying other members of the staff like, Hey, this is something we saw with this athlete, let's be mindful of not doing this, but instead let's do this". So, I think you always wanna... You gotta communicate, that's the biggest lesson. Particularly, it's something I've learned as extra important as our staff has grown, and I think it was really easy when I was a one-man show, or it was just me and another person. You could just do everything on the fly when the traffic wasn't high enough, but as our staff grew and I'm not at the facility every single hour it's open, it's physically impossible.
Eric Cressey: So you do have to empower your people and give them a chance to struggle a little bit in the best way possible, where they can actually see some of these challenging cases, because that's the only way they get better, you just... Like I said earlier, you try to set the guard rails as best as you can.
Dr. Yoni Rosenblatt: Yeah. Okay, so you map out how many weeks of that program before you sit down and reassess?
Eric Cressey: To be honest, I might have a longer term vision in my head, but I write in four-week blocks. And that's something I've always done. I think one of the worst things you can do is try to map out an entire off-season. There are some loose templates, I will kind of template out our movement stuff for the entire off-season, just 'cause I have a feel for what the calendar looks like and when do we want guys to start running bases, and when do we wanna go for more open loop as opposed to closed loop and stuff like that, when do we wanna do more time sprinting, when do we wanna compete more, when do you wanna pull back late in the off-season when our position players are taking away more ground balls and out in the outfield doing their thing? So, those are all things that I think are a little bit more templated, but for the most part, we try to give our coaches a lot of poetic license, there's certain key things like everybody's gonna train end range, rotator cuff control, and external rotations, vitally important. Everybody's gonna work on scapular upward rotation, chances are we're gonna have to do some positional breathing to get guys a little more neutral and posteriorly tilted, so you'll see competencies that we wanna see in just about everything, but I am a big believer in letting our coaches have a little bit of poetic license.
Dr. Yoni Rosenblatt: And so, the term arm care gets thrown around so frequently, how do you define arm care and where does it show up in this program?
Eric Cressey: Yeah, so arm care to me is exercise. I view manual therapy as something that's just separate and they're both wildly important to keeping people healthy, but I don't necessarily lump it underneath that umbrella. To me there's stuff that's daily, there's stuff that may be only a couple of times a week, and then there's stuff that's somewhere in the middle, yeah, some of your daily stuff and your warm ups might be your positional breathing, your scapular upward rotation stuff, your serratus activation, your end range rotator cuff control stuff along those lines, and then there's different things that you might attack in the course of a week, whether it's actual scapular control work or your classic low trap and things like that, more serratus anterior activation stuff with TRX serratus slides and bear crawls and stuff like that, certainly have actual cuff strengthening work. You can do stuff both in the sidelying position, which tends to give you better EMG, I tend to favor a lot more stuff up at 90-90 just because that's the position where guys live their lives.
Dr. Yoni Rosenblatt: Yeah.
Eric Cressey: So we'll do some manual resistance up there, you can use cables and things like that if you don't have access to manual resistance, love a lot of bottoms-up stuff, both weighted walks and carries, just to get some reflexive rotator cuff recruitment. We are doing more and more direct forum work than I think we ever have before. Everything from like, finger and wrist isometric holds to pronation, supination to radio ulnar deviation.
Dr. Yoni Rosenblatt: And what made you go that route?
Eric Cressey: I think the research is pretty compelling that your flexor carpi ulnaris takes a ton of stress off of your UCL. And I think, we're probably just doing an athlete of disservice if we don't train them through the amount of pronation and supination they have. There's also a little bit of research to suggest that, actually finger strength may have, some predictive capabilities with respect to, spin rates and potentially even protecting elbows. So I think with the epidemic of elbow issues that we're seeing, we gotta do as much as we can to, basically fortify the soft tissue structures, not just in terms of strength, but also tissue quality and manual therapy and things like that. So we are doing a lot more of that stuff, for sure.
Dr. Yoni Rosenblatt: And so if that's, if grip strengthening flexor carpi ulnaris is your kryptonite towards UCL, by the way, that's powerful. I hope that's true. What's your...
Eric Cressey: Yeah. I don't... I put it this way. I still think at the end of the day these injuries are incredibly multifactorial, but I do think it's something that, we probably could have attacked more, eight, nine years ago, and it probably three or four years ago, we really started pushing it considerably more. I think you have to be mindful because when you give guys an inch, they tend to wanna do it every day. So just being mindful of that is important. But, it's something that I think has served us well.
Dr. Yoni Rosenblatt: Did you see a change, I mean, with all this data collection, did you see a change in your injury rates or seem good with that?
Eric Cressey: You know, it's fast... Yes. I mean, I would say anecdotally, it's just so hard to really evaluate it because you're never getting the same guys each year and frankly, the average fastball velocity continues to decline. You know, it's pretty substantial. So, do I feel good about our injury rates on the private side? Yes. Like, we didn't have a single, hernia groin, calf or, quad from one of our pro guys this spring. Like, that's a big deal for every one of our position players and pitchers to get through, seven weeks of spring training without a single lower extremity thing. I mean, a knock on wood. There's always gonna be stuff that you take on.
Eric Cressey: So this is the challenge of working with throwers is, there's obviously a lot from how pitchers are built up and how workload is appreciated in different places. And you have some organizations where guys are gonna get great manual therapy and some where they can't get any. You have some organizations that are gonna feed guys great. And others they're gonna feed guys dog food and covered in vegetable oil. So, you know, there's just very different experience when they go out there. But the thing that I think has actually been the biggest confounding variable is we've actually gotten more and more broken people that have come to us. So that's the challenge is it's different. If you have a bunch of 21 year old guys with no injury history, you train them and they're, very easy.
Eric Cressey: It's what do you do when you get that 34 year old guy who's trying to eek out a couple last years of his career and he's already had two surgeries? We do tend to draw a lot more rehab cases. And, I love those cases, where I enjoy challenges and things like that. But what it does is it makes it very, very hard to scrutinize injury rates. And honestly, if you look at major league baseball injury statistics, the youngest teams always have the lowest injury rates. They generally also tend to be the teams with the lowest payrolls. So they don't necessarily bring in a lot of veteran players with accumulated wear and tear who might be high upside. But more often than not, the rosters are more transient. They're less likely to put guys on the IL for stuff that, it's a 10 to 15 day IL.
Eric Cressey: So if you have something a guy think, he might need five or six days off, like, the IL's gonna be more of a roster management thing for an affluent team that really wants the competitive advantage of like, "Hey, if you're gonna be out six days, we can't play shorthanded. You're gonna go on the IL and we'll, we'll bring somebody up who can deliver". You have other markets that just don't do that. They'll sit a guy and they'll play shorthanded just to save some money. So it's a very different thing across, different organizations. And it's not in any way, like illegal or anything like that. It's just a, it's a perspective thing that absolutely impacts some of the injury rates that are actually reported.
Dr. Yoni Rosenblatt: It is, that's a great point. It's such an awesome take and you have such a unique insight into that. I actually heard you one time, I think, so correct me if I'm wrong, you described that if individuals inside a professional organization do not have individualized strength programming, shame on that strength coach. Did you say that?
Eric Cressey: I don't know. I mean, it's, put it this way, our guys, in both the private sector and in my work with the Yankees do. Yeah. You know, that's the expectation is that everybody's, and don't get me wrong, you can, batch athletes and... See some of those, but you know, it, it's actually really fascinating to see... I don't know how familiar you are with like Peter Attia's work. I guess he had a book that just came out in the last couple days that I'm like halfway through already, it's outstanding. But he talks about kind of like medicine 1.0, 2.0, 3.0. And, 1.0 is just, it was bloodletting and, and very, very archaic. And then obviously like the introduction of antibiotics and, basically, getting rid of catastrophic disease, things like that was kind of 2.0 and, and 3.0, he talks about, it's basically heading things off. It's more proactive stuff. And, he talks about the problems with like, insurance doesn't cover, training or exercise interventions, but it will always cover metformin and...
Dr. Yoni Rosenblatt: It's crazy.
Eric Cressey: Insulin, all these things once you're actually declared diabetic, it's very backwards. I think, we're getting to, training 3.0. I don't know if maybe there's more, more layers to it. But, I think we are getting to the point where athletes are getting much, much more individualized plans. That's been a good thing that I've seen, across most organizations in professional baseball and definitely in the college setting as well. Like, there are, more opportunities for access to expertise among players. So I think it's actually trending in a much better direction. So, I don't know when we had that conversation, but it was something that, that we were doing in the private sector.
Eric Cressey: You look at the way things are staffed, like each coach probably needs to take 30 guys on, which is basically one roster and, maybe a few rehab cases and things like that. And, certainly there's Dominican academies and, international prospects that deserve a ton of attention and have so much, up developmental upside as well. So, I think it can be done. I've seen it done, we've integrated both in the private sector and, in a major league organization. So I think it's an exciting time on that Front.
Dr. Yoni Rosenblatt: It is an exciting time. First of all, Peter Attia learned how to be a doctor in Baltimore, so of course I know who Peter Attia is, but...
Eric Cressey: Another bald guy. So we... We're a good one. [chuckle] We identify with him.
Dr. Yoni Rosenblatt: That's exactly right. So, it's, I think you're right. I loved when you said that. So I'm gonna go out on a limb and say that you said that because that in the past, that was what the private sector did. That is what we do in our practice is you're one-on-one, you get an individualized case. You know, like we can't even use electronical medical records the way they're designed because every time that athlete walks in, we're giving them something just a little unique. Right? So I'm telling you, it's not in all the organizations, as you well know, and I deal with, especially a lot with pro football, it's just very rare to find these individualized programs. And I think eventually from a dollars and cents points, cents standpoint, maybe they come around on it, but it has been a massive challenge. So I love that you're changing that with the Yankees.
Eric Cressey: What I like is that it's a lot of it's athlete driven. We see players that are just intrigued, your growth mindset, they're curious. And they're going out and finding it. And to be honest, I learn from our athletes all the time like, they might go out and train with somebody else and, bring great ideas, to us when they circle back. And, I'm totally on board with that. And we collaborate with people across, various industries, whether it's, skill coaches or physical therapists or mental skills coaches. There's all different people who can help athletes be successful.
Dr. Yoni Rosenblatt: Where do you get that humble mindset? 'Cause that's what it takes. Where'd that come from?
Eric Cressey: I had to, I wasn't a baseball player. I was a third baseman up until eighth grade, and that was that. I was a much better tennis player. So, basically that was the path that I took. And so, when baseball kind of found me, I had to do a lot more listening, I'd ask a lot more questions. And, funny story, Curt Schilling was actually my first big league that I ever trained. You know, he basically had a shoulder surgery at the end of his career and...
Dr. Yoni Rosenblatt: Great oriole, by the way. That's a good oriole. Yeah.
Dr. Yoni Rosenblatt: And, I'll never forget, we were, doing some of his early stuff. He was the first, Subpectoral biceps tenodesis in major league history. So it was, very, early on in the surgery that... It's kind of jury's still out on whether it really works in throwers. But as we were talking about, like going through stuff, we'd started this throwing program. Like, I remember him talking like, "Hey, when we get this going... " And just in hindsight, he opted not to do it. He was, he decided to be a dad and to, basically go on some business ventures and all that stuff. But one of the things he said to me, he is like, "Hey, we're, when we get this further along, like, you're coming to Arizona with me". Like we're, we're doing this...
Eric Cressey: Like, we're gonna have to go throw for teams and stuff like that. He's like, "Can you do PFPs?" And I looked at him, I was like, "What's a PFP?" And he just laughs. And, I had no idea what it stood for. I mean, this is 2008, and sure enough, like it was just like a good reminder. Like, A, I have a lot to learn, but B, like the secret to this is like, he was super patient. Curt taught me a ton. Like I know he is come under a lot of fire in the media and, I will defend him, and in my... From our interactions, he was wonderful to me and taught me a ton at a really formative time in my career. And we're, we're still good friends and text often, just a guy who really took me under his wing. He had a lot to teach and I had a lot to learn. [chuckle] So I think anytime you have that opportunity to pick the brain of a guy who's, 41 at the time, I think, and has that much time in the big leagues, you, you definitely gotta soak it up.
Dr. Yoni Rosenblatt: Yeah. And, and I think what you did is you didn't pretend like you knew it, right? Like, and I was just on the field working with, an ACL. This is an ACL meniscal repair, a ALL, one of the first ALLs in the NFL. That's a lot of acronyms. And like, he's six and a half months post-op. And so we're on the field, we're doing change the direction now. I can coach the hell out of that. Every sports PT should be able to, I don't understand his job and his duty as a linebacker, as an elite level linebacker with a boot, with a play action, with a slam. I don't know where the hell he needs to be. So he is like breaking it down like I am a four year old. So, what would be worse is if I'm like, "Oh, yeah, yeah, I got this", and I give him a drill that makes zero sense, right? So like, always be humble. That's a great Schilling story. I hope one day this...
Eric Cressey: And that's true of so many people. Like Sam Fuld is the general manager of the Phillies. And, and Sam trained with us, you know, during his career probably the last five or six years. And I just distinctly remember like Sam, you went from playing next year you were like, I think he was player information coordinator in the Phillies dugout, and two years later he was their GM. So like, you don't become a GM like three years after you retire. Like there's a time flow. I trained Brandon Gomes, who's now the general manager of the Dodgers. I was cracking up today. We, actually played the Giants for opening day and Antoan Richardson, is their first base coach. He trained with us during his career. And then Craig Albernaz is their their bullpen coach.
Eric Cressey: He trained with us. I'm like, I'm getting old, but the bigger thing I look at is all these guys is, they were all curious. And, Sam reaffirmed that in the interview I did on my podcast back in the day. They're always trying to intrigue to try to find the path that leads them to the answers. And, I think in some way or another, like, we helped them to find some of those answers. And when we didn't have the answers, we showed to them that like, "Hey, we're gonna work our butt off to try to find them if we don't have the right solution for you right now".
Dr. Yoni Rosenblatt: Yeah. I was... I think Sam is so curious and so locked in individually, interpersonally. I mean, he just... I got to spend a couple weeks with him in the World Baseball Classic. And he just act... One of the very few professional athletes that looks up at me while I'm working on his shoulder, and he is like, "How many kids do you have?" Like actually, like gave a damn about the person working on him is really refreshing. So, man, you are king of Segues. Here we go. I learned to do this lightning round at the end of podcast from a genius strength coach. So...
Eric Cressey: I stole it from Robertson for the record. [laughter]
Dr. Yoni Rosenblatt: You did. Okay, fine. Well, you're great at it. So, here we go. You play, tennis against Sam Fuld, who wins?
Eric Cressey: You know, Sam's played way more tennis than I have, so I think Sam beats me for now, but if I play for a year, like I could be a good tennis player in probably two months. Like, if I really dedicated myself to it would come back really quickly.
Dr. Yoni Rosenblatt: Yes. But do you beat Sam Fuld in two months or a year?
Eric Cressey: I probably need some time. I think I'd hold my own though. I just, I don't know how much he's been playing, man. They went to the World Series. He's got like 20, he's got like 27 kids now. He's...
Dr. Yoni Rosenblatt: He's playing. Dude, he's playing.
Eric Cressey: Yeah. He's playing. That's a great one. I don't know. [laughter] I'll give him the nod for now, but...
Dr. Yoni Rosenblatt: Okay. I love it.
Eric Cressey: I believe in myself long term.
Dr. Yoni Rosenblatt: Okay. [laughter] Yeah, you're smart. Okay. Tell the world how you are at fixing things around the house and the gym. Word on the street is you're the world's greatest plumber.
Eric Cressey: Huh? I'm terrible. That was actually inside joke. I fixed the chain on the toilet at CSP one time. And so Shane, who is incredibly, like mechanically inclined, he'll fix anything. He's kind like a home improvement ninja. Shane had one of our staff members make a sign for Best Plumber ever. I'm terrible. Like, we bought a bike for our daughter's fourth birthday, and I was putting it together after she had gone to bed. And I broke it and I had... My wife had to like, ship it back and get a new one. She's like, "Don't touch this one". I'm just, I'm really good at the shoulders and elbows, but like, don't ask me to put other things together.
Dr. Yoni Rosenblatt: That's fair. That's fair. Okay, one baseball player, you wish you got to train?
Eric Cressey: Ooh, that's a great question. I'm trying to think of somebody before my time that, that I always enjoyed seeing. You know, I think... And I interact with him a little bit, really late in his career. You'd always wonder about a guy like a David Wright, like just so talented, you know, a guy like Grady Sizemore, just these guys that were... Grady Sizemore and more of like the freak athlete, David Wright obviously like an incredible talent. You always wonder what would happen if you had more, some time with them early in their career. You know, with that said, I don't think that is in any way a reflection of the people that they worked with. I think it's more just like I love the game of baseball when you see someone who, kind of, you know, their career expires before their time. Like, that's frustrating. And, I think the game should be played at a high level. So anytime you see guys like that, that retired for, various reasons that, [chuckle], were obviously injury related. It's something that makes you wonder. So....
Dr. Yoni Rosenblatt: Grady Sizemore.
Eric Cressey: Those are some of probably the two talents that, I think over the last probably 20, 25 years, you, you wonder about, right?
Dr. Yoni Rosenblatt: Yes. That's a good freaking answer. I was not expecting Grady Sizemore. Okay. The book that you most gift and why? And it can't be any of the books you already mentioned today.
Eric Cressey: No, it's all good.
Dr. Yoni Rosenblatt: Including, including, The E-Myth, which you kind of spoke to.
Eric Cressey: There you go. I think Legacy by James, I think it's pronounced Kerr, k e r r, great book. All about the All Blacks Rugby Club and, kind of how they went through a correction period and what they did to get out of the funk. Some tremendous leadership lessons. I think that one is, is really good.
Dr. Yoni Rosenblatt: That's good. Okay. I'll put that on my list. Okay. What do you wish physical therapists were better at?
Eric Cressey: I would love to have them just in general understand adaptation in the weight room more. I think we see a lot of people is they can get people asymptomatic and they can start to optimize function, but, return to play is very different than return to performance. And that's something that we see as, as really really kind of like concerning is, it's why we see athletes go back and get injured so often is that, they didn't, really like get all the way back. Like, one of the things that's really interesting is, like we rolled out probably the most aggressive base running initiative in the history of professional baseball last year. And our lower extremity injury rates went, went incredibly further down.
Eric Cressey: And now that we utilized it as part of our return to place, so that when we did have acute injuries, guys came back faster than ever before. And all the time, like people have just said, "You're gonna pull your hamstrings if you run fast". And it's the actual opposite. If you don't run fast in training and you actually go and you try to put yourself out there in competition and compete at that level, you're not prepared for it. So, I wish more of physical therapy would get to the levels that actually performance mandates. It's not just like, "Alright, you played catch at 90 feet and you're good to go, that your shoulder doesn't hurt anymore. Let's, let's keep our fingers crossed". Like, I wish they would maybe appreciate the level of adaptation it takes to really be successful over a longer term. And I know that's also heavily impacted by, insurance visit approval and. A Million, million logistics, but I do think we need to get a little bit more higher level and challenge people that way.
Dr. Yoni Rosenblatt: It is, it is influenced by insurance. But, like we said before, it's on the therapist to do that, like find an Eric Cressey and figure out how they're loading their athlete appropriately and find the latest and greatest track coaches and how are they teaching speed, stuff like that. I think it's interesting you say, "Hey, we're running more and we're getting hurt less when we run". I mean, you're describing a sensitization of so many different structures, right? And, how do we do that? And we're seeing this in the tendon world. We're seeing this in patellar tendon, achilles tendinopathy. Like, we have to create graded exposure. We have to get these athletes close to doing what they're doing, and we have to understand what they need to do. That's your point, right? We have to understand that. Okay. What do you wish strength coaches would do better?
Eric Cressey: I wish... That's probably part of a bigger discussion. I do think that the barrier to entry in our industry is too low. And, the trickle that effect of that is, I wish strength addition coaches would be more professional. I mean, that applies to all fitness professionals, not just strength addition coaches, refers, applies to personal trainers, folks like that is... I think they need to be able to carry on a more professional conversation with orthopedic surgeons, with physical therapists, with athletic trainers. Like, that served me incredibly well in my career. You know, if we're talking about this interaction, it's very different if you're, you're doing group exercise and things like that. But I think in this, like this higher level of vein, it's just so vitally important to be able to just at least speak the language so that you can collaborate, and work across these disciplines.
Eric Cressey: I sat down with our team doctor and, our head athletic trainer and our director of sports medicine and one of our players to go over MRI results and, return to action plan today. Like, that's what good care should encompass. It's sports medicine, it's strength conditioning, it's a team doctor that's, kind of critically evaluating how healing is taking place. Like that's what you want. The last thing you want is those three people or those three departments all in different rooms. And the athletes just been like, "Well, I hope he talked to that guy?"
Dr. Yoni Rosenblatt: Right. Yeah, for sure. And both ways, right?
Eric Cressey: Yes.
Dr. Yoni Rosenblatt: I wanna see that MD talk about cuff recruitment. I wanna see them talk about, protraction retraction, how to load those things. And you will find it, like I said, like the last conversation I had with the doc was eyeopening. He knew, and gave a damn a little bit about PT. Now I will say I'll go to some shoulder conferences, and these are elite level surgeons. They tell me, "Okay, first thing we do is a full body screen. And then we start". I'm like, "What does that look like? Like tell me what your full body screen looks like?" And I think they can learn from us and obviously vice versa.
Eric Cressey: I just try to get... And I'm sorry to cut you off. I just try to get in that conversation whenever I possibly can. So, case in point, saw an athlete a couple years ago who was diagnosed with a subscapularis strain, right? And what we know about the subscaps, it's a huge muscle. It kind of blends with the inferior aspect of the capsule. And one of the things that I learned in that time was that he was misdiagnosed in the first ground. It was actually a capsular injury that kind of bled through and it looked like a subscapular. And in reality it was, it was a capsular injury, which is more significant. And you know, it basically taught me, the lesson there was, anytime there's a subscap, you always referred up, the chain to someone who who can evaluate whether it's a capsule.
Eric Cressey: In some cases they'll do an arthrogram and stuff like that. And as I went through that, I had a great conversation with Dr. Altchek. He said, "Do you know one of the biggest issues with subscapularis injuries, why they're so hard to diagnose?" I'm like, "No". He talked about it on my podcast. He's like, "Some orthos and radiologists are lazy. They don't look at all the MRI segments and it's big enough and you have to hit it from all the different angles. And sometimes they just don't glance at it. If they don't see it on the first one". I'm like, "Man, it's there in front of them and they just don't look".
Dr. Yoni Rosenblatt: Yeah.
Eric Cressey: And so, it just taught me, like anytime I hear the word subscap, I immediately have an action plan. And since those conversations, I mean, I think we... Dr. Altchek was on the podcast in early 2020. I've had three or four instances where like one of them has come across my desk and I'm like, "You know what? Yeah. They're telling you to throw in two weeks. I would just be... I would feel way better if they looked to make sure this wasn't a capsule". And in like two of the four it was, and it was more of like a two month shutdown. One of them did real well with stem cells. It just was one of those, like, you have to kick the door down to those conversations and listen and take it all in and you know, and ask, questions if you're not clear on something. 'Cause invariably it's gonna help another athlete out down the road.
Dr. Yoni Rosenblatt: Yeah. I love it. You gotta go the extra mile, right? And you live it and you live what you preach because it's freaking 10 o'clock at night or whatever it is. And you're in your hotel room helping me out, just jumping on the pod. So I cannot thank you enough. You, you've been awesome with your time. You have been unbelievably responsive. Like, I'm... Don't give your email out because when I email you and you respond to me, I'm like, "What the hell's this guy doing?"
Eric Cressey: It's all good.
Dr. Yoni Rosenblatt: It's awesome. So I appreciate it greatly, Sam fuld, appreciates it greatly. But I think sports PTs around the world really just got better from that conversation. Tell everyone where they can find you.
Eric Cressey: Awesome. Well first up, thank you for having me. Social media, it's just @ericcressey on both Instagram and Twitter. The podcast is the Elite Baseball Development Podcast. You know, for the clinicians that listen there, there actually is a ton of kind of clinical based, content. We've had several, well-known orthos that have been on it. A lot of people in the research realm as well. So I think that's a probably a good resource for folks. And then the hub is kind of ericcressey.com. You can find your way to our live facilities and Florida mass, my newsletter articles, all that stuff there too. So, again, thanks for, taking the time to sit down and pick my brain. And, I enjoyed, throwing some ideas around with you. It's always good to connect. I've enjoyed our interactions over the years.
Dr. Yoni Rosenblatt: Yeah. Eric, I appreciate you and thank you so much for listening.
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