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By Carl Valle
A year ago, the article, “A Deeper Look into Medicine Ball Training,” made waves in the strength and conditioning community, and was even translated into Chinese. While it asked some very profound questions and gave great recommendations, it was hardly a training guide for coaches and athletes. Now that the history and rationale are complete, the next step is to really harness the true value of what medicine ball training can do. In this article, teaching, training, and testing are covered in great detail, along with some arguments for what should be left to other modalities.
Even in 2017, very little research on medicine ball training exists, and this void enables a lot of junk articles to proliferate on the internet and at conferences. I have seen beautiful athleticism with medicine balls, and I have seen near abuse of the body with the tool, and this article will shed some light on the reason that medicine ball training must either be done right or not done at all.
This five-step plan will help coaches and therapists drive adaptation and challenge the body better than in the past. Most of the information is very logical and based on reason, but some of the information is very progressive because of the sports science investigation performed over the last few months. Due to the lack of research and the prospect of new and more enlightening science, I was forced to dig deeper on my own.
Step 1: Throw Away 90% of Your Medicine Ball Exercises
Medicine ball training is about purpose and transfer, not just doing it because other coaches include it in their training. Nearly all of the training I see with medicine balls is busy work or junk in fitness, but in sports performance, it’s not much better. Earlier, I explained that many exercises with medicine balls are complementary and serve as bridging tools between sports skills and gross strength training. Medicine balls can help an athlete but are a far second to general progressive strength training and specific sports skills.
Exercise pruning is not a painful process, but liberation from what is just included because it “looks like it may work” to only that which works well. The exercises in your inventory must pass four simple rules, but feel free to keep the exercises in “storage” if needed. The four tests for what should be kept are:
- Does the exercise actually include a throwing or ballistic component?
- Could the exercise be done with another tool or piece of equipment more effectively or safely?
- Is the overload unique to the inclusion of the medicine ball so other options would not be appropriate?
- Can a partner enhance or create value in the movement pattern or exercise option?
These questions leave at home a lot of the exercises seen in videos and magazines with regard to athletic development. A medicine ball is exactly what its name implies—a ball for throwing—and the medicine is about addressing a specific need.
Every exercise doesn’t need to pass all four rules at once, but nearly every medicine ball exercise will pass multiple criteria. Medicine balls are controlled violence with a dose of careful training. What’s not included in the list above is a clear rationale or purpose behind the exercise, which is termed “transfer effect” in some circles. Some exercises have some general benefit that can be rationalized or argued intelligently, but some seem to stick around because the primal centers of the brain enjoy doing them or watching them. A case in point: The medicine ball slam seems to be popular, but so far, the explanations of its value have been a stretch. In my world, they would not make the cut, but similar motions or body patterns would.
There are times that medicine balls may be used when other options seem, at first glance, just as reasonable, and these are when safety matters. While a medicine ball is a weighted object, having it fall on an athlete is still less risky than a weight plate or dumbbell. I have seen many athletes break a toe, get a laceration, or receive a serious head injury from using something from the weight room instead of just using a ball to enhance loading or teaching.
I have 10 exercises I use regularly, five I use sparingly, and three to five that I use rarely. I am sure that you can comb through the internet and find 100 legitimate exercises that seem valuable, but most of the time they are only medicine ball options because a ball appears to spice things up versus coaching athletes up.
Step 2: Classify Exercises Based on Their Primary Benefit
The next step is looking at exercises based on how they help the body improve athleticism overall. Cedric and Eammon did a fantastic job outlining how they classify the exercises in this article on medicine ball training, and I recommend reading it. After studying their points and progressions, I suggest creating your own taxonomy and classifications based on your training system.
Keeping things straightforward, medicine ball training is mainly a general conditioning and specific strengthening option, or it’s a power expression opportunity. In my inventory, the medicine ball routines are for torso strength and added conditioning, outside of total body throws, of course. Most of the exercises performed tax multiple systems and overlap different classifications, as no pure exercises exist, just those that emphasize an area, more or less.
Routines that are high-repetition and continuous are considered work capacity and will develop pillar or core strength. While the research isn’t supportive of core exercises as being a solution to injury rates, having a weak torso area isn’t a good idea either. No magic muscles exist, just some seem to develop easier than others, and due to the dynamic nature of medicine balls, it’s a good idea to train them in ways that challenge the body to express the dual needs to stabilize and mobilize joints and muscle systems.
The throws are usually expressions of one part coordination and another part neuromuscular power. The primary reason why coaches, including myself, are enamored with the aestheticism of medicine ball throws is that strength and power, without the required highly coordinated actions of the nervous system, don’t transfer. Medicine ball throws that have high exit velocities require a sequence of events that encourage a “cultivating of the athletic brain garden” of sorts. The medicine ball throws for power, whether for distance or height in any direction and style, are very total-body, unlike the Bosco tests. While I include both jump tests and throws for velocity, the medicine ball movements are more total body and seem to encourage a better unfolding of the lumbar extension pattern for early acceleration than the countermovement jump. For this reason, the use of medicine ball throws is timeless for coaches and will never go out of fashion.
Torso development with medicine balls is a bit of a cliché, with coaches picturing the stereotypical slow grinding sit-ups in a boxing training montage. The reality is that good medicine ball training is total body, and the core acts as a transmission to the legs and upper extremities. Multiple planes and a wide range of muscle groups are challenged with medicine balls, usually when the athlete is forced to decelerate a distal catch with a high radial chop or rotation, before throwing the ball back. Most coaches think medicine balls are about rotation or anti-extension options, but treat them like the modern suspension of a race car, as they are not about dissipating forces but recycling energy.
Extensive or even intensive circuit-style training sessions are excellent primers for later high-intensity work, but they are not aerobic capacity workouts. While some sessions have elicited up to 20 mmol of lactate, demonstrating high changes in the pH of the blood, they are not going to help an endurance athlete kick at the end of a 10K or even a soccer player finish a game hard. Medicine ball circuits and general training are clever ways to distribute workloads generally and challenge the enzymatic processes of the body without excessive mechanical strain to at-risk joint systems. Medicine balls are restorative, as they challenge the body without exacerbating overuse syndromes.
Step 3: Teach Medicine Ball Movements from the Ground Up
While medicine balls are sometimes coined “midsection balls” because they overload the trunk, they really harness ground reaction forces from the legs when standing or kneeling and must be coached that way. The primary issue with medicine balls is that holding them or manipulating them can positively or negatively distract an athlete. An athlete who lacks natural athleticism may not be able to fully leverage the benefits of the modality if they are focusing on the ball aspect of the equipment. The catch, outside of a safe and orthopedically sound action, should be nothing more than a means to an end for the entire body.
The term and concept, “kinetic chain,” is used in biomechanics to explain how forces move through the body, usually from the ground up. Knowing how the body precisely loads the exchange of the medicine ball, either through the legs—generated from torso actions—or just by the upper body, is the name of the game. Recently, John Garrish, a strength coach in Boca Raton, gave a presentation on the importance of knowing how the body sets up or loads the medicine ball throw at a regional conference. Coaches should place most of their coaching efforts on the loading action rather than just observing the end throwing action and tossing out a cue.
Footwork is a very broad and vague term, but most of the errors seen in throwing laterally or from a run-up stem from a poor step pattern. How the weight of the body—mainly the center of mass—shifts and transfers the ball is the reason some athletes have great leg strength and great throwing ability. Many athletes are structurally blessed somewhere, but good anatomy without good coordination usually means a great weight room talent, but a poor athlete on the field or court.
Video 1. The summation of forces is the soul of great medicine ball training technique. Look to the legs and pelvis to promote better mechanics and more efficient movement with throws and other exercises.
Due to the speed of the ball, correcting or instructing medicine balls can be challenging, as the athlete’s power can mask movement errors. Assisted with lab or research-grade motion capture and EMG, I have seen that most gifted coaches will let an issue slip without knowing. The common mistake is allowing excessive rotational flexion of the lumbar spine when a ball is passed beyond the athlete’s control, and that can be a problem down the road. Training the lower back is not a bad decision, but medicine balls with high reps and after intense training sessions expose athletes to risk.
Step 4: Train with Medicine Balls Ballistically and Progress Slowly
Medicine balls are either maximal effort, total body extension exercises or elastic and rigid bracing activities. No matter what is performed, a near-maximal throw is likely necessary to generate or transfer energy sufficient to challenge the body. Outputs must be beyond honest effort but not enter the blind rage threshold that just encourages sloppy mechanics. Many training elements will aid in teaching, without requiring the excessive use of cueing. When training in large groups, the range of athlete learners is higher, making the opportunity for individualized instruction impossible. By providing clear tasks, movement strategies are usually efficient and natural ways to self-organize.
Medicine ball outputs must be beyond honest effort but not enter the blind rage threshold that just encourages sloppy mechanics.
One of the most common discussion points is the optimal ball load when the coaches don’t have the instrumentation to tease out velocity zones. Most medicine balls range from 1-6 kilograms, and some exercises must never increase the load while some will increase slowly. An athlete, even a beginner who is more likely to improve quickly, may stay on the same weight for a year or more. The problem with loads that are too heavy is that they encourage compensations to achieve success instead of doing the opposite—removing barriers to unleash power at high velocities.
In my inventory, I have shot puts, rotational throws, underhand scoops, chest throws, overhand throws, and behind-the-back throws. Some of these exercises have variations, such as the back tosses from overhead, but most of them are standing, seated, or kneeling. As I mentioned before, most of what I do consistently is only movements throughout the year, and all of them include a projection of the ball.
Athletes can do throws by themselves against a wall or trampoline, but some movements, like the total body throws, can be done in the air and allow the ball to bounce nearby. Partner work is always conditioning unless a bounce or two is used between the pass, as the risks are clear with any type of throw to another person. Early season work with partners is excellent for team building, as the athlete must rely on their partner for accurate, quality passes to improve the rhythmic quality of the sessions. As the season progresses, most of the work is going to be a maximal effort for distance or height.
Heavier balls don’t necessarily mean better, as the goal of medicine ball training is high velocity and to exploit the summation of forces from the legs to the fingertips. At times, a heavier ball can slow down a movement and overload differently, while not interfering with the goals of the exercises and, in fact, recruit muscle groups in a fresh way. For the most part, I prefer loading lighter for full extension of the body, and keeping things heavier for trunk work, provided the legs are involved and driving the movement.
Ball diameter can improve trunk contribution as the ball carrier is closer to the center of mass, relying less on the arms for contribution, especially with shot puts and rotational work. Smaller and lighter balls are great for run-up throws, similar to soccer throws and the javelin event. Overhead throws are the most deceptive of all exercises, as the amount of torque on the shoulder and the potential spinal strain are real. Athletes should keep throw counts low and use handballs and other ball types to learn before adding any weight at all. Additionally, the length of the acceleration and type of blocking action (abrupt or stumble) must all be factored in.
I have only had one athlete gets hurt with medicine ball training that I can remember, and it was his upper thoracic area that seized up for some reason. I believe the cause of this was that it was too early to do explosive work or it was one of those freak injuries, like an athlete twisting their ankle in the shower or sleeping on their shoulder funny.
Step 5: Test Medicine Ball Capacity Smarter
When the teaching priorities are satisfied, the next need is to see improvement or transfer to the sport by testing medicine ball throws. Testing medicine ball output is easy, but as I mentioned earlier, the context of how the power was created is what separates observational guessing from consistent results.
Testing does sometimes create issues with time management since the process takes longer and some movements are more difficult to measure. One way to help improve testing is to make training the same movement strategy as the tests being performed. While it may sound obvious to test the movements that you train, the real issue is how strict the movement is in testing. Some athletes will either game the movement by trying a different strategy to increase output or simply try harder and have the same challenge of keeping technique repeatable.
Some companies have provided various accelerometer products to get a measure of peak velocity of the ball or arm, but they need to see how the body created those forces is, again, the story behind the number. The priority of testing is that it’s reliable, and it requires a repeatable movement and process that can be done over and over without faults or possible errors. Focusing on the result or peak output usually results in athletes increasing range of motion, excessive use of body English that has no sign of body control, and possible adoption of a movement strategy that encourages joint actions that compromise the body.
Video does improve the reliability of testing, but only when the loading motion is analyzed and thresholds of what is acceptable and not acceptable are clear and tight. A strong cut point of what is not passing technique-wise must be nothing new to the athlete, and the training must take into account later testing. Athletes often gradually shape their movement strategies during training, so only when they have stabilized technique does testing make sense.
The use of targeting, whether for horizontal throws against a wall or for distance on a field, safeguards against much of the possible movement inconsistency. Having a narrow sector for total body throws and a small wall target raises the standard of performance while outputs from measurements can be added. In general, accountability for aiming the throw creates a governor to wild tosses and, in the long run, improves athlete power better from increases of coordination.
Through simple uses of a stopwatch and heart rate monitor for circuit-style training, you can see how various routines elicit physiological responses. Many circuits are done for time, and density work can be extremely taxing beyond the session and bleed into the next day. I have made the mistake of doing reps for time, and it usually became a slow migration to minimizing the entire body recruitment to more partial reps in order to decrease duration totals.
Parting Thoughts on Medicine Ball Training
The use of medicine balls in training has reached a bit of a ceiling with evolution today, but coaches are likely to start a renaissance with the education and technology available. Each exercise and permutation of movements should be carefully dissected and refined over time. Athletes can benefit, waste time and energy, or get injured from medicine ball training, so the odds are not in the favor of coaches who don’t do their homework. Invest in both education of training and experimentation with teaching and programming and see what works for you.
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