Arms Training for the Injured

[quote]gregron wrote:
Well obviously only training biceps and not triceps for an extended period of time will lead to imbalances.

How long cant you train tri’s? Will you injury correct itself over time with rest or does it require surgery?[/quote]

I probably can’t train triceps with any decent weight ever again. I can do kickbacks with 15 lbs and overhead extensions with 25 lbs but thats it. I have reduced its compression through nerve stretching/flossing, but of course it won’t cure it.

The only way for it to go away completely is to have surgery, but its not severe enough to warrant it. I can still benchpress (albeit only with a wider grip).

Geez man, although I have no substantive input, I am sorry to hear about having to deal with that. Definitely puts my strained back in perspective.

Tried pullovers? I feel them in my tri’s but it includes little to no elbow extension.

Post this in the injuries forum, contact BBB…

I have no clue what to do about this, but surely there’s at least some kind of surgery that can help you?

Surgery isn’t the only answer for an ulnar nerve issue. Firstly, you should figure out if it is truly an ulnar nerve subluxation or if it is an ulnar nerve inflammation or ulnar nerve impingement.

If it is truly a full subluxation where the ulnar nerve is shifting completely out of the groove, then I would expect it to be painful with benching as well as tricep isolated movements. Also, the fact that nerve flossing/glides have been helping would lead me to believe it is not a true full ulnar nerve subluxation. I obviously haven’t been able to give a physical evaluation of the elbow, so I could be completely wrong. But from the information you’ve given, I’d be more inclined to lean towards an ulnar nerve inflammatino/impingement.

In that case, the ulnar nerve flossing/glides would be a great benefit. Also, mobilization of the elbow at the ulna and radius would be of benefit to you as well as some aggressive soft tissue work to the flexor/pronator mass and extensor/supinator mass. All of those things, in addition to some proper anti-inflammatories may be enough to settle it down for you to start to progress (slowly) back to heavier weights. I’d recommend finding a good manual therapist in your area to begin some rehab.

Some things to do on your own would include some self soft tissue work to your forearm musculature and covering your elbow when you go to sleep. BBB has recommended covering your elbow and I personally, along with athletes I’ve recommended that to have seen good results just from doing that.

[quote]The3Commandments wrote:
Geez man, although I have no substantive input, I am sorry to hear about having to deal with that. Definitely puts my strained back in perspective.[/quote]

Yes it does. Makes you value what you have. Thank you for your concern.

[quote]MAsteve wrote:
Tried pullovers? I feel them in my tri’s but it includes little to no elbow extension. [/quote]

Hmm, haven’t tried them (for triceps). I’ll give them a try.

[quote]Cephalic_Carnage wrote:
Post this in the injuries forum, contact BBB…

I have no clue what to do about this, but surely there’s at least some kind of surgery that can help you?
[/quote]

BBB has given me some advice in the past, main;y involving deep tissue massaging of the forearm muscles. I have a hard time doing it on myself and no one else is experienced.

Surgery is an option I’m sure, but I don’t want to delve into it because it hasn’t been a MAJOR problem. I think surgery is a bit extreme for this case.

[quote]LevelHeaded wrote:
Surgery isn’t the only answer for an ulnar nerve issue. Firstly, you should figure out if it is truly an ulnar nerve subluxation or if it is an ulnar nerve inflammation or ulnar nerve impingement.

If it is truly a full subluxation where the ulnar nerve is shifting completely out of the groove, then I would expect it to be painful with benching as well as tricep isolated movements. Also, the fact that nerve flossing/glides have been helping would lead me to believe it is not a true full ulnar nerve subluxation. I obviously haven’t been able to give a physical evaluation of the elbow, so I could be completely wrong. But from the information you’ve given, I’d be more inclined to lean towards an ulnar nerve inflammatino/impingement.

In that case, the ulnar nerve flossing/glides would be a great benefit. Also, mobilization of the elbow at the ulna and radius would be of benefit to you as well as some aggressive soft tissue work to the flexor/pronator mass and extensor/supinator mass. All of those things, in addition to some proper anti-inflammatories may be enough to settle it down for you to start to progress (slowly) back to heavier weights. I’d recommend finding a good manual therapist in your area to begin some rehab.

Some things to do on your own would include some self soft tissue work to your forearm musculature and covering your elbow when you go to sleep. BBB has recommended covering your elbow and I personally, along with athletes I’ve recommended that to have seen good results just from doing that.[/quote]

Benching can cause problems. I do sometimes get that shifting from benching (and almost always overhead presses). That is why overhead presses are out for me. For benching, I can handle it if its a wide grip (I place my pinkies around the smooth ring of the barbell).

Yes, nerve gliding has been helping a bit, so that does give me more confidence that it can get better. I honestly don’t really care if I can’t do a triceps move ever again, I’m mainly concerned with me pressing exercises like bench and overhead press. I also wanted to work my biceps but am hesitant because I can’t work my triceps.

Do you have any sources where I can find out more about elbow mobilization and soft tissue work?

I don’t have any sources listed on the internet. I have books, but mostly would probably be over your head as they were written for manual therapists. I’d recommend going to find a qualified manual therapist in your area to help you with this situaiton.

Alright, well I thank you all that posted. I know there’s only so much that can be done. I appreciate the feedback.

Long time since I posted this, but if anyone experienced with this reads it, would arm work help to improve it or could it make it worse?

LevelHeaded makes a good point: is yours a case of ulnar sublux or impingement? You should ascertain this information.

If it is impingement, the following information MAY be helpful.

  1. As LevelHeaded and BBB suggest, you incorporate deep tissue work and wear wraps for support and warmth.

  2. Movements which involve extension at the radial ulnar joint IN THE ABSENCE of movement at the shoulder will most likely be contraindicated. They might be okay for warming up with an ultra light resistance to warm up. I would personally set up a band or cable station so you can perform what looks like a straight right (boxing) and straight left. This will allow movement at the shoulder, allow the scaps to move freely, provide some anti-rotational work in a closed-chain manner.

  3. Obviously, as the weight increases on the above exercise, it becomes primarily an anti-rotation movement. At this point, I would incorporate bw pushups at a moderate angle. The progress to regular push ups. Then, possibly feet elevated or weighted push ups.

For all variations of the push ups, I recommend using perfect push ups, blast straps, or something similar. Because the handles on the perfect push up, blast straps, etc. allow for subtle rotation (do NOT do that drastic twist in which the upper arms go to 90 degrees to torso).

Diamonds will most likely be a contraindicated movement for you.

Before the rectus abdominis, internal/external obliques, transverse ab fatigue to the point the erectors, quadratus lumborum, multifidus, iliopsoas, etc. synergistically dominate core stability, move to #4

  1. DB presses on a low incline. I suspect dbs will not lock you into the internal rotation a straight bar will. Yes, yes, yes…I know one can bring the elbows into the safer 45 degree position with a barbell. However, the dbs should allow you to find a pattern that better stimulates the three heads of the triceps WITHOUT irritating the impingement (if it is an impingement). For added anti-rotational work, one arm db incline presses are a good option (they also allow you to self spot if necessary).

You can even reverse step 3 and 4 as a form of pre-exhaust. This method favors those with less than optimal anti-extension strength in the core.

Most people are not strong enough to perform the sternum pull up. You can use the lat pull down with floating handles, lean back so the torso is not perpendicular (ie instead of the head pointing towards 12, lean back so that, with a neutral cervical spine, the head points at about 10). This will sufficiently recruit the long head of the triceps because it originates at the scap and will therefore assist with adduction in the sagittal plane.

If you noticed a common theme, you’re right. For you, tricep training will most likely involve exercising them in a synergistic role of pressing and (some) pulling in which the hands start above the torso (to activate the long head).

You also entertain the possibility that straight bar pressing/pulling are contraindicated.

And, of course, use pain as the final arbiter. In other words, if it hurts, stop immediately and re-evaluate.

To see vids of the floating handle concept, I have two vids in this thread:

(in one of the vids, I attached to a pull up bar but it just as easily be done to a lat pull down or hammer strength to allow proper float.

[quote]56x11 wrote:
LevelHeaded makes a good point: is yours a case of ulnar sublux or impingement? You should ascertain this information.

If it is impingement, the following information MAY be helpful.

  1. As LevelHeaded and BBB suggest, you incorporate deep tissue work and wear wraps for support and warmth.

  2. Movements which involve extension at the radial ulnar joint IN THE ABSENCE of movement at the shoulder will most likely be contraindicated. They might be okay for warming up with an ultra light resistance to warm up. I would personally set up a band or cable station so you can perform what looks like a straight right (boxing) and straight left. This will allow movement at the shoulder, allow the scaps to move freely, provide some anti-rotational work in a closed-chain manner.

  3. Obviously, as the weight increases on the above exercise, it becomes primarily an anti-rotation movement. At this point, I would incorporate bw pushups at a moderate angle. The progress to regular push ups. Then, possibly feet elevated or weighted push ups.

For all variations of the push ups, I recommend using perfect push ups, blast straps, or something similar. Because the handles on the perfect push up, blast straps, etc. allow for subtle rotation (do NOT do that drastic twist in which the upper arms go to 90 degrees to torso).

Diamonds will most likely be a contraindicated movement for you.

Before the rectus abdominis, internal/external obliques, transverse ab fatigue to the point the erectors, quadratus lumborum, multifidus, iliopsoas, etc. synergistically dominate core stability, move to #4

  1. DB presses on a low incline. I suspect dbs will not lock you into the internal rotation a straight bar will. Yes, yes, yes…I know one can bring the elbows into the safer 45 degree position with a barbell. However, the dbs should allow you to find a pattern that better stimulates the three heads of the triceps WITHOUT irritating the impingement (if it is an impingement). For added anti-rotational work, one arm db incline presses are a good option (they also allow you to self spot if necessary).

You can even reverse step 3 and 4 as a form of pre-exhaust. This method favors those with less than optimal anti-extension strength in the core.

Most people are not strong enough to perform the sternum pull up. You can use the lat pull down with floating handles, lean back so the torso is not perpendicular (ie instead of the head pointing towards 12, lean back so that, with a neutral cervical spine, the head points at about 10). This will sufficiently recruit the long head of the triceps because it originates at the scap and will therefore assist with adduction in the sagittal plane.

If you noticed a common theme, you’re right. For you, tricep training will most likely involve exercising them in a synergistic role of pressing and (some) pulling in which the hands start above the torso (to activate the long head).

You also entertain the possibility that straight bar pressing/pulling are contraindicated.

And, of course, use pain as the final arbiter. In other words, if it hurts, stop immediately and re-evaluate.

To see vids of the floating handle concept, I have two vids in this thread:

(in one of the vids, I attached to a pull up bar but it just as easily be done to a lat pull down or hammer strength to allow proper float.

[/quote]

I appreciate the advice man. Yes, most tricep exercises bother me, but I have found one exercise that seems to be ok, and those are body weight extensions, where I set up a bar at an appropriate height in a squat rack, get into a pushup position and bend my elbows until my forehead touches the bar, then I press right back up. Would this be ok?

Also, should I be training my biceps?

I guess what I’m worried about is if arm hypertrophy would aggravate it or actually help it.

Those body weight extensions tend to have minimal movement at the shoulder. Therefore, it qualifies as an exercise that is contraindicated.

You state the movement “seems to be ok.” How do you define “ok”? In other words, on a scale of 1 to 10 what is the pain level?

Recently, there was a polarizing article re: John Broz and his Bulgarian approach. I concede this protocol can work for a select few. However, I strongly suspect Mr. Broz’s mantra of “how you feel is a lie” is a mindset that will be the down fall of many lifters who drink this kool-aid.

My point is, certain types of pain should NOT be ignored and dismissed with a catchy phrase. When you say the movement is “ok” do you experience the wrong types of pain? If so, you may not be helping your cause by training through it (even though you might feel better as you work into it).

Re: your question about training your biceps. If possible, you need to perform pulling movements which will engage the biceps brachii in a synergistic role. As for direct training and hypertrophy, we really need to determine what exactly you have. Once you know, you will be able to apply the latest information on proper rehab. Furthermore, you will need to judiciously integrate an evidence-based approach with a sample size of ‘you.’

[quote]56x11 wrote:
Furthermore, you will need to judiciously integrate an evidence-based approach with a sample size of ‘you.’ [/quote]

FYI, I am stealing that quote. Thanks! :slight_smile:

[quote]56x11 wrote:
Those body weight extensions tend to have minimal movement at the shoulder. Therefore, it qualifies as an exercise that is contraindicated.

You state the movement “seems to be ok.” How do you define “ok”? In other words, on a scale of 1 to 10 what is the pain level?

Recently, there was a polarizing article re: John Broz and his Bulgarian approach. I concede this protocol can work for a select few. However, I strongly suspect Mr. Broz’s mantra of “how you feel is a lie” is a mindset that will be the down fall of many lifters who drink this kool-aid.

My point is, certain types of pain should NOT be ignored and dismissed with a catchy phrase. When you say the movement is “ok” do you experience the wrong types of pain? If so, you may not be helping your cause by training through it (even though you might feel better as you work into it).

Re: your question about training your biceps. If possible, you need to perform pulling movements which will engage the biceps brachii in a synergistic role. As for direct training and hypertrophy, we really need to determine what exactly you have. Once you know, you will be able to apply the latest information on proper rehab. Furthermore, you will need to judiciously integrate an evidence-based approach with a sample size of ‘you.’ [/quote]

The exercise that I deem ok does not cause the shifting of the nerve over a bone, at least not much.

I believe LevelHeaded said that based on my symptoms, it is not a full subluxation but rather an impingement. So lets give both options a consideration.

If it is a subluxation, would direct arm training be beneficial/detrimental?

If it is an impingement, would arm training be beneficial/detrimental?

[quote]forbes wrote:

[quote]56x11 wrote:
Those body weight extensions tend to have minimal movement at the shoulder. Therefore, it qualifies as an exercise that is contraindicated.

You state the movement “seems to be ok.” How do you define “ok”? In other words, on a scale of 1 to 10 what is the pain level?

Recently, there was a polarizing article re: John Broz and his Bulgarian approach. I concede this protocol can work for a select few. However, I strongly suspect Mr. Broz’s mantra of “how you feel is a lie” is a mindset that will be the down fall of many lifters who drink this kool-aid.

My point is, certain types of pain should NOT be ignored and dismissed with a catchy phrase. When you say the movement is “ok” do you experience the wrong types of pain? If so, you may not be helping your cause by training through it (even though you might feel better as you work into it).

Re: your question about training your biceps. If possible, you need to perform pulling movements which will engage the biceps brachii in a synergistic role. As for direct training and hypertrophy, we really need to determine what exactly you have. Once you know, you will be able to apply the latest information on proper rehab. Furthermore, you will need to judiciously integrate an evidence-based approach with a sample size of ‘you.’ [/quote]

The exercise that I deem ok does not cause the shifting of the nerve over a bone, at least not much.

I believe LevelHeaded said that based on my symptoms, it is not a full subluxation but rather an impingement. So lets give both options a consideration.

If it is a subluxation, would direct arm training be beneficial/detrimental?

If it is an impingement, would arm training be beneficial/detrimental?[/quote]

If we’re dealing with sublux, I cannot ethically offer any programming for the area until the issue is brought under control via an ortho and PT. In other words, I am obligated to refer you out. My particular skill set is designing an effective program that is a confluence of a person’s history, past/current treatment, and goals. I’ve met many people who were given mediocre exercise routines by orthos/pts/chiros…well, that’s not their area of expertise.

If we’re dealing with an impingement/entrapment scenario, an intelligent program (as suggested in the earlier posts) should offer benefits. However, you must absolutely be proactive in addressing adhesions - which is an inevitable by product of progressive over load. This means get those adhesions worked on a regular basis. You’ll have to experiment with different techniques as well as different therapists until you find the right combo.

ART, btw, has a method of dealing with nerve entrapment. I don’t know the efficacy of their approach but it is an option you may want to explore. The ART website has more information.

Hi. This is an old post, so thanks for anyone willing to come back to it. I am currently dealing with a sublexing ulnar nerve.

FORBES: I was wondering how you are doing with yours now years later? Did you ever need surgery? I have read statements that only surgery can correct it, and I don’t know if that’s true. Were you able to correct the problem in another way and avoid surgery?

Also, what would be the reasons for the nerve to sublex? My ortho took an EMG but did not think an MRI was necessary. Does the sublex mean I tore something? Thank again for any info.