Muscle of the Week – Brachialis

Brachialis is the “power-house” muscle that flexes the arm at the elbow (ie. bending the elbow).   It is one of several muscles that co-operate or synergize to perform this action, but is the one that is responsible for the majority of the power and force generated.   This muscle is located underneath the biceps brachii, and originates mid-way down the bone of the upper arm (the “humerus”) and ends (“inserts”) on the ulna (one of the bones of the forearm).

Muscle:   Brachialis

Location:   front of upper arm, near elbow (anterior brachium)

Main Action of the Muscle:   flexion of the elbow (bending the elbow)

Stretching Exercise:   difficult to stretch unless muscle is pathologically short.  If so, then can be done by straightening arm at the elbow   (no video for this)

Strengthening Exercise:   Perform “bicep curl” (weight in hand, bending at elbow, no movement at the shoulder) with the hand turned palm downwards.    (Video coming soon!)

Activities of Daily Living:   elbow flexion, eating, drinking, hugging.

Common Injuries:  specific injuries are rare;   occasionally tendinitis (repetitive lifting and overhead activities.

Trigger Point Referrals:    Trigger points in the this muscle can refer pain the inside of the arm just about the elbow, the front of the shoulder and also onto the outside edge of the thumb.

References:

  • Biel, A.  (2005) Trail Guide to the Body, 3rd Edition.  p. 140 Boulder, CO:  Books of Discovery.
  • Brachialis.  Retrieved March 9, 2012 from http://en.wikipedia.org/wiki/Brachialis
  • Vizniak, NA.   Muscle Manual.  Brachialis.  pg. 186-187.   Canada:  Profesional Health Systems.
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Muscle of the Week – Rhomboid major/minor

New Muscle of the Week post coming May 28th, 2012

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Muscle of the Week – Serratus anterior

New Muscle of the Week post coming May 21st, 2012

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Muscle of the Week – Subscapularis

The rotator cuff muscles form a power quartet of muscles that surrounds the shoulder joint and drives rotational movement of the shoulder.   Subscapularis is the last in this particular series of “Muscle of the Week” postings regarding the rotator cuff muscles.  This muscles starts as a broad attachment on the inner surface (next to the ribs) of the shoulder blade or scapula, and eventually ends on a smaller raised area on the humerus (upper arm bone) near the shoulder joint.   All of the rotator cuff muscles help to stabilize the shoulder joint, and this muscle in particular drives the rotation of the shoulder joint inward (medial / internal rotation).   This muscle is quite prone to myofascial trigger points.  Trigger points in this muscle result in a deep ache in the back of the shoulder and can refer pain down the back of the upper arm and an achiness on the back of the wrist.

Muscle:   Subscapularis

Location:   on the inner surface of the shoulder blade (between shoulder blade and ribs)

Main Action(s) of the Muscle:    

    • Rotation of the shoulder inwards (internal/medial rotation)
    • Stabilizes the shoulder joint

Strengthening Exercise:   Resisted internal rotation – lay on floor or exercise bench on your side with arm closest to the bench bent to 90 degrees.  Using this same arm/hand, hold weight and then bring weight from resting position up in arc towards the body.   Return to resting position and repeat.   (Video coming soon!)

Stretching Exercise:   Stand in doorway and place hands on top of door jam with palm against the wall.   This stretch is initiated via bending the body forward and dropping the head between the arms.  Continue this movement until a stretching sensation is felt in the back or sides of the shoulder.   (Video coming soon!!)

Activities of Daily Living:   reaching behind the back, throwing, racket sports

Common Injuries:   The muscle itself is rarely injured.    Injury of the tendon (tendonitis) from repetitive forceful internal rotation – swimming, a lot of throwing, a lot of work directly overhead – commonly occurs.

Trigger Point Referrals:    Myofascial trigger points in this muscle refer pain deep in the back of the shoulder, and can radiate pain down the back of the upper arm.   An ache in the back of the wrist is also considered a signature of possible subscapularis trigger points.   Trigger points in this muscle can lead to weakening due to pain resulting in an imbalance between the four rotator cuff muscles and potentially leading to a clicking or popping sound.

References:

    • Biel, A.  (2005) Trail Guide to the Body, 3rd Edition.  p.82-86.   Boulder, CO:  Books of Discovery.
    • Davies, C and Davies, A.   The Trigger Point Therapy Workbook, 2nd Ed.  pg 93-96.  Oakland, CA:  New Harbinger
    • Subscapularis muscle.  Retrieved April 4, 2012 from Wikipedia http://en.wikipedia.org/wiki/Subscapularis_muscle
    • Grays Anatomy plate 411. (2006). Gray411.png (online image)  Retrieved April 4, 2012 from Wikipedia http://en.wikipedia.org/wiki/File:Gray411.png
    • Vizniak, NA.   Muscle Manual.  Subscapularis.  pg. 174-175.   Canada:  Professional Health Systems.

For more information or to inquire about your specific situation, please contact me:

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Muscle of the Week – Pectoralis major

Pectoralis major is the major muscle of the anterior (front) chest.   It also forms the main “show-piece” and “powerhouse” muscle of the chest.   This muscle starts broadly along the breast bone, rib cartilage and along the collar bone, and ends on the edge of a groove (the bicipital groove) on the upper bone of the arm.   This is one of the main muscles which drives the rotation of the shoulder inward (internal/medial rotation).   This muscle is also important in maintaining the stability of the shoulder joint.   Trigger points in this muscle can lead to local pain, as well as referred pain into the front of the shoulder and along the inner part of the arm and into the side of the hand and the 4th and 5th finger.  Muscle pain and dysfunction in this muscle can lead to disturbed posture with a forward rounding of the shoulder which can then lead to pain and further trigger points in muscles of the upper back and neck.

Muscle:   Pectoralis major

Location:   front of the chest

Main Action(s) of the Muscle:     

    • Bringing arm towards the side of the body (adduction)
    • Bringing arm across the chest (horizontal adduction)
    • Rotation of the arm inwards (medial/internal rotation)

Strengthening Exercise:    Simple exercise is to do the standard “push-ups”.   Optionally, lay on an exercise bench, holding weights in each hand, arms extended to the side.   Weight is lifted up and over the body in a controlled arc.   (Videos coming soon!)

Stretching Exercise:   Often referred to as the “doorway stretch”.   Stand near a door way with your body at 90degrees to the doorway entrance.   Bring arm up to 90-degrees out from the body and bend elbow to 90-degrees.   The forearm is placed against the door-jam, and then the body is rotated slightly away until a stretch is felt in the chest.   The location of the stretch in the chest can be changed by varying the angle that the upper arm makes with the body.    (Videos coming soon!)

Activities of Daily Living:   hugging, applying deodorant, wrestling, pushing an object away

Common Injuries:    overuse tendinitis in athletes and body builders.  Rupture is rare.

Trigger Point Referrals:      Trigger points from this muscle refer pain locally in the chest, in the front of the shoulder, down the inner aspect of the arm/elbow and into the pinky-finger part of the hand and into the 4th and 5th fingers (pinky finger and the one next to it).   Trigger points in this muscle also tend to keep the shoulders rolled forward and put strain on the muscles of the upper back (trying to keep the shoulders back).   Pectoralis major trigger points can also lead to carrying the head forward and lead to trigger points in the sternocleidomastoid and scalene muscles.

References:

    • Biel, A.  (2005) Trail Guide to the Body, 3rd Edition.  p.97-99.   Boulder, CO:  Books of Discovery.
    • Davies, C and Davies, A.   The Trigger Point Therapy Workbook, 2nd Ed.  pg 134-137.  Oakland, CA:  New Harbinger
    • Pectoralis major muscle.  Retrieved April 3, 2012 from Wikipedia http://en.wikipedia.org/wiki/Pectoralis_major_muscle
    • User-Nikai. (2005).   Pectoralis_major.png  (online image)  Retrieved April 3, 2012 from Wikipedia http://en.wikipedia.org/wiki/File:Pectoralis_major.png
    • Vizniak, NA.   Muscle Manual.  Pectoralis major.  pg. 114-115.   Canada:  Professional Health Systems.

For more information or to inquire about your specific situation, please contact me:

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Muscle of the Week – Teres minor

Teres minor is the third, in this series, of four muscles that comprise the group of muscles commonly known as the rotator cuff.   This group of muscles is key in the movement of the shoulder.   This muscle starts on the outer edge of the shoulder blade and eventually ends at the outside top end of the humerus (upper arm bone).   Teres minor, along with the other rotator cuff muscles, helps stabilize the shoulder joint, and is one of the muscles that drives rotation of the shoulder outwards (also known as lateral or external rotation – think of bringing a stop-sign up using your shoulder to rotate it upwards).    While this muscle is prone to trigger points, they are often masked by trigger points in other muscles.   Taking care of trigger points in those muscles will reveal whether trigger points exist in this muscle.

Muscle:   Teres minor

Location:    shoulder;  lateral (outside edge) of the shoulder blade going to the top of the upper arm bone;  passes along back edge of the axilla (arm-pit).

Main Action(s) of the Muscle:  

    • Lateral (external) rotation of the shoulder
    • Stabilizing upper arm bone (humerus) into shoulder joint
    • Adduction of shoulder (bringing arm towards the body from the side)

Strengthening Exercise:   Laying on side, holding upper arm against the side of the body and forearm at 90-degrees.  Hold weight in hand, and the lift weight up in arc until end of range is reached (Video coming soon!)

Stretching Exercise:   Seated, place hands on waist with thumb facing backwards.  Lean forward slightly and then let elbows fall towards the floor.   Stretch can be deeped by pulling on elbow with hand of other arm.

Activities of Daily Living:   Brushing hair back, cocking phase of throwing motion, backhand of racquet sports

Common Injuries:   Strain (muscle tear) with forceful external rotation of the arm, repetitive strain injury due to repetitive external rotation, can be injured during shoulder dislocation

Trigger Point Referrals:    Trigger points in this muscle tend to refer pain to a very specific zone on the back of the shoulder close to where the muscle attaches to the bone of the upper arm.   Trigger points in this muscle can also cause a numbness or tingling in the fourth and fifth finger.

References:

    • Biel, A.  (2005) Trail Guide to the Body, 3rd Edition.  p.82-86.   Boulder, CO:  Books of Discovery.
    • Davies, C and Davies, A.   The Trigger Point Therapy Workbook, 2nd Ed.  pg 92-93.  Oakland, CA:  New Harbinger
    • Teres minor muscle.  Retrieved March 29, 2012 from Wikipedia http://en.wikipedia.org/wiki/Teres_minor
    • Lennert B. (2005). Arm_muscles_back_numbers.png  (online image)  Retrieved March 29, 2012 from Wikipedia http://en.wikipedia.org/wiki/File:Arm_muscles_back_numbers.png
    • Vizniak, NA.   Muscle Manual.  Teres minor.  pg. 172-173.   Canada:  Professional Health Systems.

For more information or to inquire about your specific situation, please contact me:

E-mail:   scott@swbmassage.ca

Website:  SWB Massage Therapy

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Muscle of the Week – Rotator Cuff #2 – Infraspinatus

Infraspinatus is the second, in this series,  of four muscles that comprise the group commonly known as the rotator cuff muscles.  This group of muscles is key in the movement of the shoulder.   The name infraspinatus literally means “below the spine”, but in this case means below the spine of the scapula or shoulder blade.   The bony ridge that can be felt as a part of the shoulder blade, if you start at the “point” of the shoulder and work towards the midline of the body while also moving downwards on the body is the “spine” of the scapula.   Infraspinatus one of the muscles that helps stabilize the shoulder joint, and is also responsible for rotation of the shoulder outwards (also known as lateral or external rotation – think of bringing a stop-sign up using your shoulder to rotate it upwards).    This muscle is also extremely prone to trigger points in those people that work with arms above their heads, people who drive extensively with their arms up high on the wheel, and people who sit at desks on chairs with no arm rest support.

Muscle:   Infraspinatus

Location:    on the outward facing portion of the shoulder blade below the ridge / spine (infra-below;  spinatus – spine)

Main Action(s) of the Muscle:

    • lateral/external rotation of the shoulder
    • stabilizing the shoulder joint  

Strengthening Exercise:   Laying on side on floor or weight bench.   Bring upper arm across the body with elbow bent to 90o, holding weight in hand.   Lift weight up and away from the body, keeping elbow locked against the body, until the weight is directly overtop of the body (if possible).    (Videos coming soon!!)

Stretching Exercise:    For the side being stretched, put the back of the hand on the hip.  This will start the stretch.   If possible, with the hand of the other arm, grasp the elbow and draw it gently towards the other side of the body.   A stretching sensation should be felt on the back of the shoulder.   (Videos coming soon!!!)

Activities of Daily Living:   brushing hair back, back-hand in racket sports, cocking phase before throwing a ball

Common Injuries:   repetitive strain from forceful external rotation of the arm (too much throwing of a ball, etc.) can lead to tendonitis;  work that keeps the arms above the head a lot and working at a keyboard without elbow support can lead to overworked infraspinatus

Trigger Point Referrals:    Trigger points in the infraspinatus muscle commonly refer pain to the front of the shoulder and the outside of the shoulder, and occasionally down into the thumb side of the hand.  Pain from highly activated trigger points can often also be felt deep in the shoulder joint.

References:

    • Biel, A.  (2005) Trail Guide to the Body, 3rd Edition.  p.82-86.   Boulder, CO:  Books of Discovery.
    • Davies, C and Davies, A.   The Trigger Point Therapy Workbook, 2nd Ed.  pg 90-92.  Oakland, CA:  New Harbinger
    • Infraspinatus.  Retrieved March 21, 2012 from http://en.wikipedia.org/wiki/Infraspinatus
    • Image from Gray’s Anatomy.  Retrieved March 21, 2012 from Wikipedia http://en.wikipedia.org/wiki/File:Infraspinatus.PNG
    • Vizniak, NA.   Muscle Manual.  Infraspinatus.  pg. 170-171.   Canada:  Professional Health Systems.

For more information or to inquire about your specific situation, please contact me:

E-mail:   scott@swbmassage.ca

Website:  SWB Massage Therapy

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