More on Forearm and Wrist Strength: Pronation and Supination

More on Forearm and Wrist Strength:

Pronation and Supination

 

 

In previous posts I spoke about forearm, wrist and hand grip strengthening in the direction of elbow flexion (Bottoms Up Bicep Curl), wrist flexion and extension, and wrist radial and ulnar deviation both dynamically and statically with the focus on maintaining wrist stability while a resistance is applied at a certain direction.  Today I will discuss training forearm pronation and supination. 

 This photo is of my hand, wrist and forearm in the neutral position holding a dumbbell

 This photo is of my hand moving into the pronated position

 This is a photo of my hand in the supinated position
 

Moving from neutral to pronation and back to neutral holding the weight in this manner is training the supinators

 

        

Moving the weight from neutral to the supinated position and back to neutral is training the pronators 

 To make the above exercises more challenging, just increase the length of the lever you are trying to move (Here I use a Persian Mil) - Neutral Position

Pronated Position

 

 
Supinated Position
 
To add even more of a challenge, add thickness to the handle using Neurogrips.  This will challenge your grip as well as your forearm strength

Neutral Position Using Neurogrips

 

 

Pronated Position Using Neurogrips
 
Supinated Position Using Neurogrips

 And now to challenge your grip and forearm muscle endurance... Maintain a static position of your hand, wrist and forearm while a pronation or supination force is applied:

 Here, the Persian Mil apply a force in the direction of forearm supination and in order to prevent any motion, the pronators must contract isometrically while I perform kneeling rear delt lifts

Here, the Persian Mil apply a force in the direction of forearm pronation and in order to prevent any motion, the supinators must contract isometrically while I perform kneeling rear delt lifts

 

Try the above progressions to further improve your grip strength

 





Flat Feet and Knee Pain

Flat Feet and Knee Pain

 

As a Physical Therapist, you are taught not to have "tunnel vision" when considering a painful body region.  It is recommended that you "look" (assess) one joint above and one joint below that painful area.  Knee pain can have many causes.  Although the pain may be felt at the knee joint, the source of the pain many times is at the foot/ankle joint.  As a clinician, assess your client for flat or pronated feet. 

 The left foot would be considered pronated or "flat" as you can see by the angle drawn
 
 
The pronation of the foot creates medial or internal rotation of the tibia/lower leg.  To see this, stand up and flatten the arch of your feet.  Do you feel the medial/internal rotation of your lower legs?

Upon doing this, your knees will slightly turn in toward each other.  

 

If the pronation is not corrected, then this medial/internal rotation will happen with activity such as jumping.  This inefficient movement pattern may be the source of your knee pain.

 

Many times, this type of knee pain will be felt along the inside/medial aspect and inferior/lower aspect of your knee cap especially upon jumping or stair climbing (descent).  One initial treatment for this condition is to purchase an over-the-counter arch support/orthotic to place in your shoe. 

This will maintain your arch, and limit the "down and in" medial rotation of your lower leg.  Muscle length and strength should also be assessed in order to improve your condition.  Finally your movement patterns should be assessed and corrected.

 

Knee Mechanics: Down and In

Knee Mechanics: Down & In

Watching your client's jumping mechanics can tell you a great deal and potentially help you prevent or recover from knee injury.

Down and In Video

This athlete presents with a "down and in" motion of both lower extremities upon jump and landing.
 
What does this tell you?
1. Your client may have overly pronated ankles or flat feet possibly due to tight gastrocnemius, soleus or subtalar joint
2.  Your client may have a tight Ilio-tibial band or Tensor Fascia Latae musculature
3.  Your client may have weak gluteus medius

How do you work with this client?
1.  Stretch the gastrocnemius and soleus
2.  Stretch the ITB/TFL and use a foam roller for deep massage
3.  Strengthen the posterior Glute Medius with clamshell or prone figure four exercises
4.  Practice the intended motion with proper technique...Work the movement pattern and the muscle timing will follow

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