The Truth About Pec Strains

Pectoralis major

Justin Ware and I were talking about pec strains the other day, so I figured this would be an opportune time to discuss how pec strains come about in the gym.

Now, keep in mind (as many are more than willing to note) I'm not a therapist, so I'm not going to discuss treatment strategies.  Rather, let's discuss how pec strains come about in the first place, as well as how to avoid them.

The pec strains that I've seen over the years can typically be traced back to one of two issues:

1 - Poor programming which leads to overuse, and/or

2 - Scapular instability

Let's discuss each a little bit more in depth.

With regards to programming, it's like anything else - a lot of issues arise when you increase volume, intensity, or both, too quickly. Runners are notorious for this.

You see it time and again - little Johnny reads about the "blow up your pectacles" or "increase your bench 50 pounds in 2 months" and goes from 15 sets of bench in a workout to 30.  It's amazing what the body can adapt to, but every body has its threshold.  All those stupid things you do over the course of months and/or years will come back to haunt you. 

If you're reading this blog, I'm assuming you already know that structural balance is important.  As well, you also realize that you have to be judicious when raising volume and intensity, so let's look at #2 instead.

Scapular instability is another huge cause of pec strains.  You'll see this quite often in bench pressing - you should be able to keep your scapulae retracted and depressed throughout the set.  If you are unable to do this, you've reached what many would call technical failure. This is a critical component of training that many overlook.

Your prime movers might be able to crank out more reps, but you lack the appropriate stability to do so safely and effectively.  Going beyond technical failure is where many pec strains occur - you exceed your body's ability to appropriately stabilize your scapulae, and the pec gets overloaded.

This is why getting a hand-off is so important; you want to set up nice and tight through the upper back.  Not getting a hand-off often results in "pushing" the bar out of the supports, versus "pulling" it out.  This is a very subtle distinction (and one I stole from Dave Tate), but it makes a huge difference in your stability throughout the set. If you "push" the weight out, you often lose your scapular position and stability.  "Pulling" the weight out, along with a hand-off, keeps you in the appropriate scapular position throughout.

Injuries are a part of the iron-game; if you push things hard enough (and long enough), chances are an injury will crop up at some point in time.  However, smart training and adherence to basic principles will go a long way to keeping you healthier and stronger for a lifetime.

Stay strong

MR

(If you'd like more info on the bench press, check out the following articles: Defending the Bench Press and Yo, How Much Ya Bench?)

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Glass Boxes and Softball Players

Billy Wagner

The other day I was perusing my Facebook inbox, and read over the following message:

Mike -

I have been enjoying your Assess and Correct program and learning lots. Thanks so much.

Had a little problem with a group of 8th and 9th grade softball girls that just started with us. They all are very weak and none of them could do one good push-up. We started them with Blast Strap rows and Incline BB Push-ups and got this email:

"This is Dad X, Player Y's dad. Player Ys pitching coach (TC) believes that push-ups and pull-ups put to much stress on the rotor cuff. Any chance the coaches could give her a different exercise/drill? Could you please pass this on.

Thanks for your help and time.

Dad X"

This coach was looking for some insight, so my first thought was to ask Eric Cressey, who works almost exclusively with baseball players these days.  This first snippet is a quote from his upcoming chapter on baseball testing and assessment:

"One thing I mention to all my baseball players is that it is important to realize throwing a baseball can hardly be considered a natural act.  In fact, the velocities one encounters during overhead throwing of the baseball are actually the fastest encountered in sports.  During acceleration, the humerus internally can rotate at velocities faster than 7,000°/s (1), while the elbow may extend at greater than 2,300°/s (2).  This act of acceleration imposes tremendous stresses on osseous, musculotendinous, ligamentous, and labral structures at the elbow and shoulder girdle.  These stresses are magnified with throwing off the mound as compared with flat-ground throwing."

But Eric goes a little further as well:

7,000 degrees per second is the SINGLE FASTEST MOTION IN SPORTS!!!!  And they're worried about pull-ups and push-ups?  The cuff really takes the most abuse in the extreme cocking/lay-back postion and at ball release (although it is working in the middle a lot, too) - both of which constitute an end-range-of-motion. Pull-ups and push-ups don't hit those extremes.

It's shocking to me that some coaches still buy into myths such as this one.  Assuming that a properly executed push-up is possibly more injurious than throwing is ludicrous.  If we want to take it to the extreme, how are we going to tell kids to get up off the floor?  You'd better not lay on your stomach and do a push-up to get up, lest you injure your rotator cuff in the process!

But, I digress.

It's interesting that exercises such as push-ups and pull-ups (closed-chain activities which actually increase 'cuff and stabilizer activation) are demonized, while bench presses and lat pulldowns are key constituents of many beginner training programs.  For almost any athlete, push-ups and pull-ups should be key components of their general preparation.  As mentioned above they are actually quite "shoulder friendly," but they also build total body-awareness, strength, and motor control.

If you (or the pitching coach) wants to have a better understanding of how the scapulae and rotator cuff work together to promote functional, pain-free movement at the shoulder I'd highly recommend checking out Bill and I's previous article Push-ups, Face Pulls and Shrugs.  Not only do we look at the biomechanics and functional anatomy, but we review quite a bit of research as well. 

If I could make only one suggestion with regards to this coaches programming, I would remove the blast strap rows for the time being.  If these girls are really this week, I would imagine that their core stability/strength is poor, as is their upper back strength.  Give them a stable environment (such as a traditional inverted row) to begin with until their strength comes around. 

Good luck with your training, and hopefully the girls understand what a great coach they have!

Best

MR

Comments (1)

Hammer Those Hips!

Kurt Warner

It seems as though hip pain and dysfunction is a real hot topic as of late.  I can’t tell you how many e-mail inquiries, as well as new clients, I’ve seen in the past couple of months that dealt with some sort of hip dysfunction.

Not surprisingly, as we become better at diagnosing hip issues, it seems as though more and more people are opting to undergo hip surgery versus exploring more conservative therapies.  I don’t have stats to back this up, but it definitely seems to be the case.  Add into the mix that professional athletes like Kurt Warner, Alex Rodriguez and Carolos Delagdo have undergone hip arthroscopies in the past year, and it’s no wonder why the hip is quickly becoming a hotly discussed joint.

In many cases, hip dysfunction can be misdiagnosed due to where the actual pain is noted.  For instance, hip dysfunction can obviously lead to hip pain, but lack of control and strength from the hips can also lead to lower back and knee pain as well.  In poorly designed interventions, the focus is put on the site of the pain, versus the site of the underlying problem.

What’s more, while many people are quick to talk about hip mobility, hip strength and motor control are imperative as well.  I often describe the hips as the functional centerpiece of our body.

In my opinion, restoring hip function is a two-step process:

1 – Restore motor control to the dysfunctional muscle group(s)

2 – Regaining strength, both in isolated and integrated movements

When discussing hip motor control/strength dysfunction, we’re generally discussing the psoas, glute max, and/or posterior gluteus medius.  When a client or athlete lacks the necessary strength or motor control, this often leads to synergistic dominance (the wrong muscle performing the desired movement), increased likelihood of injury, decreased strength and performance, and increased wear and tear to the joint.

Obviously, there’s a lot more to the equation than what I’ve outlined here, but this is a topic I’ll be discussing in more depth going forward.  For more information on this topic, as well as how to get those hips fixed up and moving appropriately, be sure to check out my article “Hips Don’t Lie,” as well as the Assess and Correct DVD and manual which will be released later this year.

Stay strong
MR

Comments (1)

My shoulders hurt!

No more shoulder pain...

Last week, I evaluated a potential new client at IFAST.  She was in fantastic shape overall, as she’d already been exercising for over 5 years straight.

The problem, however, was her shoulders – she was complaining of poor mobility, and some general pain and discomfort when exercising.

As I was going through her assessment, it took me about 2 seconds to determine the primary problem.  But, to add a little suspense to the equation, let me begin by telling you what wasn't the problem.

Her pec and lat length were fine.  As well, her internal and external rotation were not only acceptable, but pretty symmetrical as well.  So that obviously wasn’t the case.

When evaluating people with shoulder pain, you tend to see a lot of instability, especially through the scapulae – but this wasn’t the case here.  For the most part her scapulae were stable, and her rotator cuff tested only mildly weak.

The biggest issue in her case, however, was her thoracic spine position.  As I’ve mentioned numerous times in the past, the thoracic spine is the foundation for your shoulder function – if your t-spine isn’t aligned properly, you can never get your scapulae into the appropriate positions.  And when your scapulae are out of whack, it’s only a matter of time before you have some sort of shoulder issues.

If you’re having shoulder issues, you absolutely, positively have to acknowledge the role of the thoracic spine, and make sure it’s in optimal alignment.  Bill and I discussed this extensively in our Inside-Out DVD.  As well, if soft-tissue restrictions are part of the problem be sure to check out my Soft Tissue e-manual.  It’s absolutely free, after all!

I know people want to show how smart they are and discuss all the intimate links within the body, but sometimes the simple answer is also the correct one.  Address the t-spine in your shoulder clients and I guarantee better results.

Stay strong
MR

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