Watching David Attenborough is a real indulgence. The man’s knowledge of the biology and intricacies of natural science form a marvel of fascination. There is such a depth of understanding and intrigue to be gained from indulging in any of his BBC series that deserve all the laudits and praise it receives. In talking about procreation and ‘signalling’ it is wonderful to hear that incredibly distinctive voice talking of the ‘visually delectable display that is the power of the male form in all it’s colourful bravado and courtship’. It is easy to fall prey to this man’s divine vocal ramblings as he explains and expouses the amazing dexterity of nature to provide visual displays that are in it’s simplest form – STUNNING.
Arm flexion is as vital to the male homo-sapien in courtship as are the colours of the bower bird in it’s visual display of dancing and den inspection (yes it’s true – a tidy home brings in the gal). And so many males value the impressario that is the biceps brachii. The muscle of courtship so to speak. And so oft is it overused and developed at the expense of other, more intrinsically valuable and much more functionally important muscles of the arm. Brachio-radialis cops a short deal in the actions of arm flexion and is the truly overlooked, poorer star of this action to biceps brachii. The biceps whilst impressive, should not be focused upon for the efficiency of the action. Ipso facto, elbow flexion is ruled by brachio-radialis as well as the Supinator muscle. I bring up supinator as mostly people who are training biceps Brachii in action = i.e elbow flexion and lifting bicep curls targets supination at the elbow to enable to action. Thus supination can be the contributing element to elbow pain and issues that comes about from overtraining the biceps muscle at the gym.
The supinator muscle has often been referred to in generic terms as the one who causes supination of the forearm in general. The term supinator longus was actually used to refer to brachio-radialis, the other bicep muscle and the one that is actually more involved with the famed elbow flexion than the ever popular biceps brachii.
The power of supination is most important in the anatomy and the ability of the biceps brachii to perform the action that is desired by so many avid gym trainers. It is also surprisingly useful when it comes to actions of the forearm and holding racquets, weights, bars, bats and golf clubs. Yes even golfers can suffer from a bad supinator!
Where the supinator muscle decreases in efficiency, up to 64% of power is disabled in the action of forearm supination. This can render the action of elbow flexion much more difficult as you are relying on muscles that are primarily involved with flexion, to maintain supination of the forearm to be able to grip and hold the arm in the right position to perform the move. It can also have direct consequence on the nature of how someone involved with any ‘bat based’ exercise such as golf or tennis, to be abel to execute the necessary movements that allow you to hit a topspin forehand or a complete driving chip from the turf. Thus the ability to be able to perform a bicep curl, baseball swing or even a swimming stroke can be more to do with the power of supination than of elbow flexion.
The supinator is a dual fibred muscle that has its origin at the lateral epicondyle of the humerus (upper arm bone) and inserts on the lateral upper third of the radius (forearm bone backhanded side). It is a broad, flat muscle that acts in cohesion with biceps brachii, and contains the deep branch of the radial nerve. This latter point of interest is most important when it comes to considering the management of chronic pain in the forearm (in reference to last weeks article on RSI and forearm pain). Occlusion of the radial nerve can result in decreased function of the posterior part of the forearm and in particular that back side of the wrist, thumb and first two digits of the hand. It also has indications on elbow flexion, working with the arm in an extended position (behind the shoulder) and with the arm in full flexion with rotation. This has rather interesting implications when it comes to doing one’s hair or putting on a t-shirt in the morning. These minor irritations can be related to this muscle directly.
Any flexion or extension of the elbow that is deemed painful or of discomfort can in fact be influenced by the supinator and it’s function. Shortening in the muscle can result in the forearm being unable to rotate during elbow flexion which means that performing actions where you bring a resistance load up to your shoulder, can be minimised or even reduced if the supinator is unable to bear the load. At the other extreme, being unable to maintain a ‘palms up’ position against resistance with the shoulder in extension, (such as backstroke or an upward throw of a ball) can also be influenced by a shortening in this muscle.
Ideally, it is with the overtraining of biceps and elbow flexion that often you will find ‘gym bunnies’ coming in for treatment of this condition. The pain on the lateral elbow which can also sometimes be confused with ‘tennis elbow’ is sometimes more applicable to a shortening of this muscle if the client has been involved in ‘beefing up the biceps’. Draining through the broad flat apex of the muscle can bring about relief and can even make the actions of elbow flexion pain free – particularly on moves such as Deadlifts, supinated chin ups, bicep curls, hammer curls etc.
So if you are hitting it hard in the gym and finding that your elbows are starting to suffer, or that there is sharp pain when you do go for those extra sets of ‘peaked guns’ preacher curls, perhaps you need to look at getting your supinators into the best health – theres’ no point having ‘great guns’ if you can’t supinate your forearm to be able to show them off! Although perhaps if you are finding it difficult to deal with pain in the lateral elbow and you are struggling with diagnosis of ‘tennis elbow’ and not really getting results, perhaps you are not addressing the right muscle. Working on the supinator can have a direct result in reducing the amount of load at this insertion and creating a pain free elbow flexion and rotation of the lower arm against the upper arm. And when it comes to sports, that can make all the difference to having a forehand that is a killer on the court, or making it through that back 9 on the golf course.