I. Description of Motion:
Bringing the anterior surface of the forearm toward the anterior surface of the arm, hinging at the elbow joint. Normal range of motion for elbow flexion is from 0-150 degrees.1
Primary Muscles- Biceps brachii (Musculocutaneous Nerve- C5,6,7)2
Secondary Muscles- Brachiialis (Musculocutaneous- C5,6,7 and Radial Nerve- C5,7) and Coracobrachialis (Musculocutaneous Nerve- C5,6,7)2
II. Mobilizing – Increasing Range of Motion :
1.) Overhead Triceps Stretch
a.Start by sitting in a chair or standing upright with back straight.
b.Raise your left arm overhead and bend it so your hand is as close as possible to the middle of your back.
c.Your left arm and forearm should be close to touching.
d.Then reach over with your right hand and grasp the elbow of the left arm with your right palm facing down.
e.Pull your left elbow backward and toward the right side slowly until you feel a stretch down the back of your arm.
f.Keep shoulders down throughout the movement.
g.Hold for 30 seconds and repeat stretch 3 times.
Feeling Patient Should Experience: Stretch down the back of their arm from the shoulder to the elbow
2.)Cross Body Triceps Stretch
a.Start by sitting in a chair or standing with your back straight.
b.Reach your left arm across your body, parallel to the ground at shoulder level.
c.Take your right hand and place it on the outside of your left elbow.
d.Pull your left arm towards the right side of your body slowly until you feel a stretch down the back of your arm.
e.Keep shoulders down throughout the movement.
f.Hold for 30 seconds and repeat stretch 3 times.
Feeling Patient Should Experience: Stretch down the back of their arm from the shoulder to the elbow
3.) Overhead Triceps Towel Stretch
a.Stand straight with good posture and grab a small towel with your right hand.
b.Raise your right arm above your head and bend it to dangle the towel behind your back.
c.Bend your left arm and curl it behind your lower back to grab the dangling towel.
d.Gently pull the towel with your left arm until you feel a gentle stretch in your right triceps.
e.Hold for 30 seconds and repeat stretch 3 times.
Feeling Patient Should Experience: Stretch down the back of their arm from the shoulder to the elbow
III. Indications for Stretching:
The most common conditions/indications requiring mobilizing or stretching to obtain more elbow flexion are tight triceps, elbow arthritis, elbow dislocation and elbow flexion contractures from bracing/splinting/casting. 3,4
IV. Strengthening:
Include THREE strengthening techniques/activities that can be effective in increasing strength in your selected motion. Identify how you might progress the activity from easy to harder to improve strengthening. Identify the frequency each technique should be performed.
1.)Cross Body Hammer Curls
a.Start in a standing position with weights in left hand and thumbs pointing towards body.
b.Keep posture upright and abdominals braced.
c.Bend from your elbow and bring weight towards your opposite shoulder shoulder.
d.Return to starting position.
e.Proceed to do another repetition.
Frequency: Complete 3 sets of 15 reps.
Progression: Increase weight
2.)Bicep curls
a.Start in a standing position with weights in both hand and thumbs pointing away from body.
b.Keep posture upright and abdominals braced.
c.Bend from your elbow to bring the weights towards your shoulder.
d.Return to starting position.
e.Proceed to do another repetition.
Frequency: Complete 3 sets of 15 reps.
Progression: Increase weights and/or supinate/pronate wrist to activate other elbow flexors
3.)Static Holds for Biceps
a.Start with left elbow bent to 90 degrees.
b.Place your right hand on your left wrist
c.Apply a downward force with your right hand while resisting with your left arm.
d.Hold for 15-30 seconds.
e.Release pressure on left arm
Frequency: Complete 3 sets of 15 reps.
V. Potential Clinical Syndromes or Etiologies:
1. Biceps Tendonitis
2. Elbow Flexion Contracture
3. Elbow Arthritis
VI. Additional Web Based Resources:
1. http://www.bodybuilding.com/fun/glen14.htm
2. http://www.innerbody.com/image/skel14.html
3. http://www.exrx.net/Articulations/Elbow.html#anchor764071
VII. References
1.Moore KL, Dalley AF, Agur AMR. Chapter 6: upper limb In: Clinically Oriented Anatomy. 6th edition. Philadelphia, PA: Lippincott Williams & Wilkins; 2010:670-819.
2.Hislop HJ, Avers D, Brown M. Chapter 5: Testing the muscles of the upper extremity. In: Daniels and Worthingham’s Muscle Testing. Techniques of Manual Examination and Performance Testing. 9th edition. St. Louis, MO. Elseivier; 2014:79-202.
3.Huang J. Elbow Arthritis | UW Orthopaedics and Sports Medicine, Seattle. Available at: http://www.orthop.washington.edu/?q=patient-care/hand/elbow-arthritis.html. Accessed December 6, 2014.
4. Kuschner SH. Elbow Dislocation. The Journal of Bone and Joint Surgery. 2002:253-258. doi:10.1007/0-387-21533-6_23.
By: Brittney Roberts
