Sunday 8 April 2018

Arms, Shoulder and Neck Stretches



with Megan Prenty, RMT Yoga Teacher 






Anatomy & Symptoms


1.  Forearm Flexors

The Forearm Flexors are a group of four muscles that make up the inside of our forearm. These muscle all begin just above the inside of the elbow at the common flexor tendon on the humerus bone of the upper arm. This group of muscles runs along the palmer side of the forearm and attach along the bones of the wrist and the hand. This muscle group is predominantly responsible for extending the elbow and flexing the wrist, or bending the wrist to bring the palm towards the inner arm.

This group of muscles is commonly tight and full of adhesions in people who spend extended periods of time on a computer or engaging in other repetitive and fine motor skills with the hands or wrists. These repetitive motions can result in muscle shortening and tension which have symptoms that mimic, or can even cause, carpal tunnel in the wrist. This tension can also create nerve and vein impingements which can result in symptoms of numbness, tingling, shooting pain, and a lack of circulation in some or all of the fingers. These impingements can occur nearer to the elbow, as with pronator teres syndrome, or closer to the wrist, as with carpal tunnel.

Another common injury to this muscle group is medial epicondylitis, often known as golfer’s elbow, which is a form of tendonitis that affects the attachment at the elbow. You don’t have to be a golfer to get golfer’s elbow - in fact this condition commonly occurs in people who have repetitive elbow and wrist movements, particularly when coupled with palm-down weight bearing. Typically this is identified as pain at the inside of the elbow during or after elbow and wrist activity such as playing golf, tennis, weightlifting, wrist flexion, and other small movements like turning a doorknob, shaking hands, or using the hands while the palm is face down.

To stretch the Flexors of the forearm, we should bring this muscle group to a place of length. To do this, begin seated and bring the shoulder to 90 degrees with an extended arm and straightened elbow. Begin to extend the wrist backwards and pull the fingers towards the ceiling. Feel the stretch appear across the inside of the elbow along the forearm and to the wrist. Hold it for 30 seconds, then repeat on the other side.

Another way to perform this stretch would be positioning yourself on your hands and knees (see video for image). The elbow should be straight and the fingers should be pointing towards the knees with the eye of the elbow pointing away from the body. This version of the stretch will address both sides of the arms at the same time. To increase the line of pull, you can gently start to sit backwards lowering the pelvis over the hips until the stretch is comfortable through your arms. Ensure you hold the stretch for 30 seconds.

Trigger point balls are particularly helpful for manual release as they help to broadly focus on this group of forearm muscles. For more specific and isolated work through the arm, use a smaller ball - bouncy balls work great. To use a ball, straighten the elbow and gently roll the ball side to side horizontally across the inside of the forearm. Ensure that you work from just above the inside of the elbow and focus on the inside (pinky side) of the arm. When you find tender spots increase your focus there until the tension subsides. Ensure you roll the ball in small movements in a side to side motion. Your pressure should be a comfortable depth as you work on each side. Work both sides of the arms for an equal length of time beginning with a suggested two and a half minutes each side and increase as needed.



Pro tip - if you sit at a desk, keep a bouncy ball close by and build it into your daily routine to ensure the arms aren't tightening and shortening through the work day and week.


2.  Forearm Extensors


The Forearm Extensors are a group of four muscles that make up the outside of our forearm. These muscle all begin just above the outside of the elbow at the common extensor tendon on the humerus bone of the upper arm, running along the back of the forearm to along the bones of the wrist and the hand. This muscle group is predominantly responsible for extending the elbow and wrist, or bending the wrist to bring the palm facing away from the body with fingers pointing upwards.

This group of muscles is commonly tight and full of adhesions in people that spend extended periods of time on a computer or engaging in other repetitive and fine motor skills with the hands and wrists. These repetitive motions can cause muscle shortening and tension that can in turn cause trigger points and send pain along the back of the arm. This tension can create nerve and vein impingements which produce symptoms of numbness, tingling, shooting pain, and a lack of circulation in some or all of the fingers.

Another common injury to this muscle group is lateral epicondylitis, commonly known as tennis elbow, which is a form of tendonitis that affects the attachment at the elbow. You don’t have to play tennis to get tennis elbow - in fact this condition commonly occurs in people who have repetitive elbow and wrist movements, particularly when coupled with palm up weight bearing activities. Typically this is identified as pain at the outside of the elbow during or after elbow and wrist activity such as playing tennis, weightlifting, repetitive wrist extension, and other small movements such as turning a doorknob, shaking hands or using the hands while the palm is face up.
































To stretch the Extensors of the Forearm we should bring this muscle group to a place of length. To do this begin seated and bring the shoulder to 90 degrees with an extended arm and straightened elbow begin to flex the wrist forwards and pull the fingers towards the floor. Feel the stretch appear along the outside of the elbow along the forearm and to the wrist and hold it for 30 seconds. The repeat on the other side.

Another way to perform this stretch would be kneeling on hands and knees (see video for image). The elbow should be straight and the fingers should be pointing towards the knees with the weight through the back of the hand. In this posture the eye of the elbow pointing towards the body. This version of the stretch will address both sides of the arms at the same time. This is a very sensitive so be sure the line of pull is comfortable. To increase the line of pull you can gently start to sit backwards lowering the pelvis over the hips until the stretch is comfortable through the arms. Ensure you hold the stretch for 30 seconds.



Trigger point balls are helpful for manual release particularly to get into this group of forearm muscles broadly. For more specific and isolated work through the arm use a smaller ball - bouncy balls work great. To use a ball effectively straighten the elbow and gently roll the ball side to side horizontally across the back of the forearm. Ensure to work from just above the outside of the elbow and focus on the inside (pinky side) of the arm. When you find tender spots increase your focus there until the tension subsides. Ensure you roll the ball in small movements in a side to side movement. Your pressure should be a comfortable depth as you work on each side. Work both sides of the arms for an equal length of time beginning with a suggested two and a half minutes each side and increase as needed.



3.  Biceps Brachii
Commonly known as the Biceps, this muscle runs from the top of the shoulder blade and inside of the shoulder joint capsule and then along the front of the upper arm, attaching just below the elbow on the Ulna bone of the forearm. Biceps is responsible for multiple actions: primarily it is responsible for supinating the forearm (turning palm upwards) and flexing (bending) the elbow, and also assists in flexing the shoulder.
This muscle is commonly the cause of shoulder pain that originates from the front of the shoulder. This pain is most  often from chronic muscle shortening or a tendonitis of the Biceps. Chronic muscle shortening is commonly seen in computer users and athletes. When the arms are held with a bend at the elbows the muscle is in a shortened state; being in this posture for prolonged periods can create a chronic shortening. Muscle imbalances also occur commonly in weightlifters who omit stretching and don’t equally focus on exercising the Biceps antagonist muscle Triceps. Tendonitis of the bicep tendon is common in people who do work with repetitive elbow bending, especially if the muscle is under load as when lifting is occurring.
To stretch Biceps Brachii we must bring the muscle to a place of length. Begin with your hand on a table or stool with your fingers pointing behind you. Begin to straighten the elbow and bring the shoulder into extension by leaning forward. A line of pull should develop from the top of the forearm, across the elbow, and up the front of the upper arm to the shoulder. Once you feel a comfortable pull up the front of the arm hold it for 30 seconds before repeating on the other side.
Trigger point balls are helpful for manual release. To work with a trigger point ball use one hand to apply pressure as you roll the ball horizontally left to right along the front of the arm from the shoulder and work the way down just past the front of the elbow. Ensure your pressure is a comfortable depth as you work on each side. Work both sides of the arms for an equal length of time beginning with two minutes each side and increasing as needed.



4.  Triceps Brachii



Triceps Brachii are commonly referred to as the Triceps, and are a large muscle that makes up the bulk of the back of the upper arm, working in opposition to the Biceps. The Triceps muscle has three different heads which connect the back portion of the scapula (shoulder blade), along the back of the long bone of arm - the Humerus and the back of the Ulna of the forearm. Triceps Brachii has several functions but primarily extends or straightens the elbow. Triceps also has an important role in arm stabilization when the forearm and hand are engaging in fine motor movements as well as a supporting function in adduction of the shoulder.

Common conditions affecting this muscle is Tricep tendonitis at the portion of the muscle near the elbow. Another common injury affecting the Triceps comes from over-stretching, particularly when strength training through this muscle has been lacking. Typically injuries in Triceps are seen in athletes, particularly in sports which incorporate weight bearing and throwing movements.



To stretch Triceps Brachii we must bring the muscle to a place of length. Begin by bringing one arm up above your head, tuck your chin in, and bend this arm at the elbow while tucking the hand along the upper shoulders. With your opposite arm grab the elbow and pull into the midline of the body. A line of pull should develop from the back forearm, crossing the elbow and up the back of the upper arm to the shoulder. Once you feel a comfortable pull up the back of the arm, hold it for 30 seconds before repeating on the other side.

Trigger point balls are helpful for manual release. To use a trigger point ball for Triceps, pin the ball between yourself and a wall of on the floor with the ball at the back of the upper arm. If this is the first time you have done this stretch or if your tricep is actively hurting, I suggest starting with yourself leaning along the wall so you can adjust your depth with more sensitivity. Ensure your pressure is a comfortable depth as you work on each side. Gently roll the ball from side to side horizontally as you move it from the top of the upper arm to the bottom of the elbow along the back of the arm. Make sure to work both sides of the arms for an equal length of time, beginning with two minutes each side and increase as needed.

5.  Deltoids


The Deltoids are a small muscle in the shape of an inverted triangle that sit at the top of the upper arm. This fan shaped muscle attaches from the clavicle in the front of the body and wraps around the side of the body to include the outer portion of the acromion and spine of the scapula. This muscle inserts in the Deltoid tuberosity which is a small bump in the outer portion of the top third of the upper arm. This muscle is responsible for abduction of the arm away from the body. When this muscle is isolated into different fibers (anterior, lateral and posterior) it supports the muscles of the rotator cuff as well as abduction of the arm.


The Deltoids can be overworked and cause painful contractures and trigger points when we carry weight with straight arms. Because the Deltoids are responsible for moving the arm away from the body they engage and contract to be able to hold weight with a straight arm without it bumping into the body itself. Especially if we carry a great deal of weight at once, say carrying all your grocery bags in one trip when really it be best if it was two or three trips. One way to avoid this common injury is to not overload the muscle. Reduce your carrying weight where possible and when you do carry heavy loads insure to stretch afterwards.




To stretch the posterior portion of the Deltoids, we must bring the muscle to a place of length. Begin by securing the shoulder towards the hips and ensure space between the shoulder and the ears. Bring this arm across the chest, gently secure this arm with the other hand. A line of pull should develop from the back portion of the upper arm where it meets the shoulder. Once you feel a comfortable pull up the top of the back portion of the shoulder hold it for 30 seconds before repeating on the other side

Trigger point balls are helpful for manual release. To use a trigger point ball use one hand to apply pressure as you roll the ball horizontally left to right along the side of the upper third of the arm. Ensure your pressure is a comfortable depth as you work on each side. Work both sides of the arms for an equal length of time beginning with one minutes each side and increase as needed.


6.  Upper Trapezius


This is a large, broad diamond-shaped superficial muscle which covers most of the upper back. Trapezius runs from the base of the skull and attaches on the lower thoracic (mid back) vertebrae as well as extends outwards to attach along the spine of the scapula (shoulder blade). This muscle is primarily responsible for moving the scapula and supports the weight of the arm.


Common conditions affecting the trapezius muscle include myofascial trigger points. Due to poor posture, this muscle is often over lengthened, weakened, and susceptible to small tears which cause painful adhesions and knots in the muscle. These trigger points, or muscle knots, are common causes of muscle pain and are the source of tension headaches which wrap around the side of the head like a question mark. The upper portion of Trapezius is often tense in people under stress and those who sit for prolonged periods.

To stretch the Upper Trapezius we must bring the muscle to a place of length. Begin by securing the shoulders towards the hips and ensure length through the neck. tilt your head to one side, bringing your ear toward the shoulder. A line of pull should develop from the lengthened shoulder, up the neck, to the base of the skull. Once you feel a comfortable pull up the side of the neck from the shoulder and hold it for 30 seconds before repeating on the other side.

Trigger point balls are helpful for manual release particularly to get into the neck muscles broadly. For more specific and isolated work through the neck use a small ball - bouncy balls work great. To use a ball use one hand to apply pressure as you roll the ball from the shoulder along the side of the neck from the shoulder to the ear. Ensure you roll the ball from the front to the back of the body. Ensure your pressure is a comfortable depth as you work on each side. Work both sides of the arms for an equal length of time, beginning with one minutes each side and increase as needed.


7.  Levator Scapula


Levator Scapula is a small muscle that runs from the top of the shoulder blade to the sides of the top four cervical vertebrae. This muscle connects the back body at the shoulder blade to the neck. As its Latin name suggests, Levator Scapula is responsible for lifting the shoulder blade.

Levator Scapula syndrome can result in those who sit for long periods with poor posture. Forward head carriage and slouching posture through the back will irritate this muscle causing localized and referral pain, inflammation of the muscle, stiffness, and decreased range of motions. The increased tension on this muscle from poor posture can create adhesions and trigger points which can result in pain and tension related headaches. Dysfunction and adhesions in this muscle is commonly associated as a cause of localized neck pain and headaches.


To stretch Levator Scapula we must bring the muscle to a place of length. Begin by securing the shoulders towards the hips and ensure length through the neck. Bring one ear towards the same shoulder as your head tilts to one side just as with the upper trap stretch. From this position turn your chin towards your armpit and tuck it in slightly. A line of pull should develop from the top of the shoulder blade and travel up the neck to the side of the neck. Once you feel a comfortable pull from the shoulder to the side of the neck and hold it for 30 seconds before repeating on the other side.
Trigger point balls are helpful for manual release, particularly to get into the neck muscles broadly. For more specific and isolated work through the neck use a smaller ball - bouncy balls work great. To use a ball bring yourself into the stretch and use one hand to apply pressure as you roll the ball from the top of the shoulder blade and along to the side of the neck. Ensure you roll the ball in small movements side to side. Your pressure should be a comfortable depth as you work on each side. Work both sides of the arms for an equal length of time, beginning with one minute each side, and increase as needed


8.  Scalenes


Scalenes are a group of three small muscles (anterior, middle, and posterior) that run along the front of the neck. These muscles originate on the cervical vertebrae two through seven and attach to the first and second rib. The primary action of this muscle group when engaged one side at a time is to bend the head to the same side. When contracted bilaterally this muscle group helps to lift the first and second ribs during inhalation.

This muscle is a common location of impingement in thoracic outlet syndrome. In this condition, muscles that are overly shortened or inflamed can press on the nerve, arteries, and vein bundles where they exit the neck and travel down the arm. Symptoms of thoracic outlet syndrome include pain and weakness that travels along the neck to the arm. Nerve symptoms like shooting pain or numbness can also be present. This injury commonly occurs from repetitive movements with the arm and neck, as well as poor posture. Scalenes are at risk of becoming short and tight especially in people with asthma or during cold and flu season when people are forcibly coughing.






To stretch Scalenes we must bring the muscle to a place of length. Begin by securing the shoulders towards the hips and ensure length through the neck. Bring one ear towards the same shoulder as your head tilts to one side just as with the upper trap stretch. From this position turn your chin towards the ceiling. A line of pull should develop long the front of the neck to just below the collarbone. Once you feel a comfortable pull from the shoulder to the side of the neck and hold it for 30 seconds before repeating on the other side. Ensure to take deep and comfortable breaths while in the stretch.

Trigger point balls are helpful for manual release particularly to get into the neck muscles broadly. For more specific and isolated work through the neck use a smaller ball - bouncy balls work great. To use a ball bring yourself into the stretch and use one hand to apply pressure as you roll the ball along the front of the neck working from the collarbone to the outside upper portion of the neck. Ensure you roll the ball in small movements in a side to side movement. Your pressure should be a comfortable depth as you work on each side. Work both sides of the arms for an equal length of time beginning with one minute each side and increase as needed.









While stretching is generally safe for everyone, it is best to talk to your doctor or medical health professional before undertaking a new exercise routine. This is especially true if you have any pre-existing conditions, injuries, or particular concerns. If you have questions about anything mentioned in this blog or for booking contact email Megan directly by e-mail: megan@thecoachhousetc.ca
Namaste

Megan Prenty RMT, YT

Wanting more resources like this one? Be sure to check out the rest of the series - the Lower leg , Thigh self care , Glute and Hip self-care and Trunk -back and chest.Be sure to follow The Coach House on Facebook and Instagram to keep in touch and get notifications of new blog posts.


Disclaimer: The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for general educational purposes only. This information shouldn’t take the place of seeing your primary care provider for individualized health recommendations.

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