Forearm Training and Straining

Several common forearm injuries can plague trainees. The best known is tennis elbow, an acute or chronic strain at the origin—that is, tendon attachment—of the wrist extensor muscles on top of the forearm. Strain and pain on the bottom of the elbow are often called golfer’s elbow, and I’ve discussed that pain in regard to triceps training several times. The last strain is to the large muscle of the forearm, the brachioradialis. Strains to that muscle can linger and be very resistant to treatment.

The brachioradialis has a broad origin on the lower portion of the humerus, or upper-arm bone, and inserts, or attaches, by a long tendon to the thumb side of the wrist. It’s the largest muscle of the forearm and its function is to flex, or bend, the elbow. It helps partially turn the palm upward, which is called supination, or downward, called pronation, and it’s used strongly in pulling movements—for example, pullups, pulldowns and all types of rows.

Those movements develop the brachioradialis sufficiently for many trainees. If you want more development, you can perform hammer curls in your arm workouts. Many powerlifters incorporate hammer curls because they feel that the movement helps supports the arm and elbow during very heavy bench presses.

Overtraining can strain the brachioradialis. So can carrying heavy items for long distances. Examples include moving dozens of boxes to and from trucks while moving in or out of your home or carrying luggage through an airport. Once that muscle is strained, you become aware of how many exercises involve it. Suddenly, your back and arm workouts are compromised.

Trainees typically train lighter, hoping that the problem will pass quickly, but, as previously noted, the strain tends to linger. The next step is to stop training back and arms. Even so, a trainee may have to travel and grabs a suitcase. Halfway across the airport, the brachioradialis begins to significantly ache. Handling the luggage has aggravated the injury, delaying recovery.

Medical treatment usually includes combinations of anti-inflammatory medication, soft tissue mobilization, ultrasound, electric muscle stimulation and laser. For reasons that are not clear, brachioradialis strains are resistant to treatment. That means the problem can last for many weeks or months.

A strain of the wrist flexors, on the bottom of the forearm, is usually aggravated by triceps training when the wrist is not kept straight. When the wrist bends upward—wrist extension—there’s a stretch on the flexor muscles, and that pulls on the tendons and origin. The stretch is magnified when the injured trainee tries to force an extra rep or two by accelerating the bar through the movement. The strain usually resolves when he or she learns to keep the wrist straight during triceps training.

A strain of the wrist extensors on top of the forearm at the elbow, known as tennis elbow, can also linger. It’s usually the result of a combination of overuse and the weakness of the wrist extensors. Strengthening the wrist extensors will improve tennis elbow. That idea is circulating through the Internet today as if it’s a new discovery. It isn’t. I learned it in biomechanics courses in the late 1970s. The traditional reverse wrist curl is a great exercise for the wrist extensors, as is using a wrist roller.

Keep in mind that these muscles are used in many activities. That’s why it’s painful to shake someone’s hand during an acute episode of tennis elbow. While reverse wrist curls will help—start with very light weight—other exercises may aggravate tennis elbow. I often see trainees in the gym performing laterals with their wrists bent downward, or flexed. That loads your elbow unnecessarily.

A little preventative work can save your elbows and keep you in the gym and training. Train smart, then train hard.

Editor’s note: Visit www.SoftTissueCenter.com for reprints of Horrigan’s past Sportsmedicine columns that have appeared in IRON MAN. You can order the books, Strength, Conditioning and Injury Prevention for Hockey by Joseph Horrigan, D.C., and E.J. “Doc” Kreis, D.A., and the 7-Minute Rotator Cuff Solution by Horrigan and Jerry Robinson from Home Gym Warehouse, (800) 447-0008 or at www.Home-Gym.com.