How can I regain strength in my arms?

Whether you’ve suffered an injury, or you’ve had your mobility compromised, it can be difficult to rebuild the strength and range of motion (ROM) for your arms. Healing alone can take weeks, even months, and sometimes ineffective training after an incident can lead to long-lasting loss of muscle and strength. 

Before you begin to strengthen, speak with your medical practitioner and be certain the injury is healed. We are often taught to power through pain, but we are not often shown what that means for our body when it isn’t fully healed. Tearing new muscle over an injury can cause pain and damage to the new tissue, which leads to a longer period without full function.

So, while you are still in the healing process, your MO will either recommend complete rest, or they will give you some practical ways to improve your prognosis. Methods can include heat on stiff muscles, or ice on tender, swollen ones. KT tape may also be employed to improve the pain of daily activity and alleviate stress on specific areas.

Knowing where to start to improve shoulder function, discomfort, or limited range of motion is a frequently asked question, so the purpose of this post is to help understand the full range of motion available in the shoulder so that the reader can take this information and apply therapeutically in a way to support discrepancies. If the range of motion is restricted by discomfort or weakness, lessen the intensity and work under that threshold with low to zero weight or resistance, and let that be the starting point. If ROM is restricted by muscle tension, consider the all ranges of motion of the shoulder, and apply a stretching technique where indicated.

Strengthening and Stretching techniques can be applied to any range of motion and descriptions will be found in Step 3.

Step 1: Assessment

Once you are ready to re-engage your muscles, an MO can assess the tissues being affected by your injury and they can recommend tests to pinpoint the problem(s). They should ask about your history to discover any repeat injuries or dysfunction. They should also ask you about your daily routines and what sorts of triggers cause you discomfort or pain.

  • They will observe your arms in various positions and movements to determine if there are impingements, scar tissue, or other lingering effects. Often numerous muscles are involved for any particular action, work with your MO to assess the damage and residual symptoms so that your treatment plan can incorporate the various tissues involved.

There are six key Ranges of Motion (ROM) in the glenohumeral joint (shoulder joint) to take into consideration as you target specific areas of the arms. Your MO will be able to show you proper technique for each muscle group, but do consider these actions when deciding to strengthen the shoulders globally.

Let’s start with Flexion and Extension – If there is discomfort, a reminder to reduce range of motion or weight/resistance so that work is done under the pain threshhold. If the shoulder can not move into full extension or full flexion, ensure weight/resistance is low to improve strenghtening, and follow with a stretch after full strengthening cycle. Utilize the other arm to support a gentle stretch of the arm in the range of motion of restriction. This theory can be utlized in any ROM, strengthen first, then stretch. Only hold static stretches when telling the body it can relax and no longer needs to perform as in: at end of workout or end of day. Dynamic stretches are important in the interim, review Step 3 for more information about these stretching techniques

Flexion 90°

Full Flexion 180°
Extension

Strengthen lateral flexion (abduction) to 90° maximum range of motion unless rotating wrist palm up. The structure of the proximal humerus bone will prevent excess movement unless the integrity is compromised.

Flip the the palm up if the goal is full ROM, which coincidentally (not really) is the exact same as full flexion
This is the full medial rotation ROM- a fabulous stretch
Medial Rotation
Lateral Rotation
Full range of motion for Lateral Rotation, a fabulous stretch after strengthening. 
 
You may recognize this combined stretch technique for Lateral and Medial Rotation. Be gentle, stretch to comfort only, then the goal here is to inch fingers closer together using a towel or band. This can take months to return to a healthy ROM and it looks different for everyone. 

2 BONUS ROM-

  1. Horizontal Adduction
Horizontal Adduction
Horizontal Adduction
Starting position to demonstrate full horizontal adduction or abduction
Horizontal Abduction

Step 2: Treatment 

Your MO will be able to perform manual adjustments and massage with you during your visit AND they will be able to recommend exercises at home. Pay attention to the subtle corrections to your alignment and posture and be willing to ask questions!

Regardless of the site of weakness, the emphasis needs to be on slow, smooth movement through a full range of motion. Though you may be targeting different muscles, you want to encourage proper form and an even development of the muscles. It is important to exhale on the action when strengthening, utilizing the exhale as a driving force to complete an action.

Targeting Forearms

Exercises for the forearms will still engage the biceps and triceps, and can include standing dumbbell curls and hammer curls, along with tricep extensions. Before you begin, your MO will want to take note of your starting point for ROM and strength, to later gauge your progression.

Dumbbell curls: Stand with feet shoulder width apart and comfortable, Dumbbells in each hand, held loosely, in a neutral position (meaning your thumb is forward, not turned in or out to the side. Avoid locking out your knees, elbows, or wrists. Keep everything relaxed. Then when you begin the curl, your thumbs naturally rotate out so that your palms face up at the end of your flexion. Your upper arms remain at ease, and you simply bend at the elbow. When you slowly reverse the curl, your wrists rotate to return with thumbs forward.

Match your breathing to the exercise by breathing out when you curl, and breathing in when you lower back down. Emphasize smooth, even breath with smooth, even motion. Begin with less weight, until you can easily and fluidly add more.

Hammer curls: Begin with the same stance as a dumbbell curl, but do not rotate the wrist as you lift. Rather, hold the dumbbell as if it were a hammer the whole time. You can curl one arm at a time to maintain proper form and then take the curl across your body in order to target more of the biceps.

For the sideways curl, begin with your arms held loosely at your sides, then bend one arm at a time, at the elbow, with the dumbbell crossing your body and lining up parallel to your torso. Follow the same smooth line of motion to return to the starting position and remember to breathe out as you curl and in as you relax. 

Triceps Extensions: You can do this exercise from a standing or seated position. Hold one dumbbell between both hands by gripping one end between your palms, hands in a triangle around the shaft. Raise the dumbbell above your head into position. Keep your elbows glued to your ears, meaning the bend is in the elbows, not the shoulders. 

When you bend your elbows, you will lower the dumbbell behind your head. By mindful of the weight and difficulty of this exercise and remember that the exercise should be smooth and precise. You can breathe in as you lower the weight behind you, and breathe out as you raise it again.

Targeting Biceps

Bicep injuries tend to stem from repetitive strain, or from maxing out with heavy weight. You can use curls to target biceps of course and you can use bands to provide lengthening.

Use weights or a band with enough stretch to comfortably hold under both feet and get into the curl position with your feet close to shoulder-width apart. You can find a range of exercises that help to strengthen not only your biceps, but also the smaller muscles which serve to support your arms’ ROM.

Targeting Triceps

A tricep tear can be rehabilitated with weights and band work also and although people may be hesitant to purchase bands, there are benefits to the investment. Otherwise, a towel may be used for gentle dynamic stretching.

This global stretch also targets the triceps- With one elbow bent above the head, hold the top of the towel, and with your other hand gripping the bottom behind your back, softly and evenly pull the towel down, keeping some resistance to protect your shoulder and elbows.

Targeting Shoulders

When people say they’ve injured their shoulder, that could have implications for multiple muscles and ligaments intersecting at the head of the humerus bone. Shoulder shrugs can be helpful for muscles including the trapezius and levator scapula. Abduction or lateral flexion is great for deltoids, suprispinatus and biceps. Flexion for anterior deltoids, pectoralis major, biceps brachii, coracobrachialis and suprispinatus. Extension for triiceps, latissimus dorsi, teres major, and posterior deltoid, the lists goes on. Working with an osteopathic practitioner can help identify target areas and tissue globally and focally.

Food for Thought

Normalize exercising your arms so that you have a steady routine you can count on until you return to your original strength and musculature. Incorporate a healthy diet so that your body is nourished and thriving. 

Joint rotations: Simple wrist, elbow and shoulder clockwise and counterclockwise rotations can help to maintain healthy ROM for each joint in your arm. Roll your shoulders forwards slowly ten times, breathing steadily, and then change direction. Do ten elbow circles, following the natural bend and extension of the joint, before changing direction and repeating the process. Follow up with ten wrist circles going both directions. 

Gentle stretching can help relieve tight muscles after they’ve been worked out. Avoid overstretching or “pulsing” (repetitive stressful pressure during the stretch). Instead think about relaxing into each stretch so that your muscles are elongated and allowed to freely release and lengthen.

Arm stretches can include the following:

  1. With both of your arms forward, fold the fingers of your hands down so that the back of palms are touching and hold there gently, to stretch the top of your forearms. You can press lightly on the backs of your fingers/palms to increase the stretch. Count to ten and then release. Then hold your fingers up and with palms together, feeling a gentle stetch on the other side of the forarm. An alternate way for these areas could be one hand at a time on a table standing at waiste level instead, stretching palm side and back of hand side aiming to have a flat hand in either direction. Feel the stretch, keep elbow gently bent or straight to target different muscles. Activate hand lightly for a moment, then relax further into a deepening stretch.
  2. Stand facing the corner of a wall and lay your arm against the wall with your palm touching the wall. Twist your body forward and away from your outstretched palm so that you feel the stretch in your biceps. Hold or pulse. 
  3. Next hold your arm across your body and press the back of your hand against the wall, or hold the extended wrist with your other hand. Twist your body towards your bent arm to feel the stretch along your triceps and deltoids.

HELPFUL HINTS

-If you do not have weights, use bands. 

-If you do not have bands, use household items like soup cans.

-If there is pain beyond mild discomfort, try focusing on slow range of motion work, without weight. Find a pain free range of motion in each of the 6 directions and let that be where you start, and build up weight, and ROM as you improve muscle tone and strengthen and finally stretch.

-Remember, even though this is focus for arms, the whole body should be engaged meaning:

– Strong posture

-Slight bend in the knees

-Weight in the heels of feet

-Strong and engaged stomach with the belly button towards the spine

-Tuck your chin, lift your head and lengthen in the spine

Step 3: Repeat

There can be hesitation about following up with your MO once the first treatment is complete, but it’s important to observe and report back on what improvements you’re seeing (or not seeing) and which exercises you’ve kept up with.

Regardless of where you are in your healing and strengthening process, an MO can provide guidance because they know how to assess for specific injuries or dysfunctions and what actions to prescribe.

An easy workout for strengthening the arms is to choose one of the 2 following types of exercises:

*Isotonic Exercise: Producing limb movement without change in the muscle tension. The action is performed on the exhale.

10-12 repetitions, 3 sets, 1-4 times a week. (30 seconds- 1 minute break between sets)

*Isometric Exercise: Meaning the muscle stays the same length. Hold contractions for 5 seconds, 8-10 reps 2-3 sets, 1-4 times a week. (30 seconds to 1 minute break between sets) 

* Stretching time can be anywhere from 2 seconds to 2 minutes, depending on the goals set with your practitioner. Keep range of motion healthy, and do not stress joints which are hypermobile or with ligament laxity into exagerated or intense ranges of motion.

*Dynamic Stretching– Gentle stretches with little to no holding time, pulsing, pendulum swinging, or gentle passive or active circles of the joint to ease into stretch, without fully relaxing tissue. Most benificial mid sport/activity/day, or times when the body will still need to be ready for action.

*Static Stretching- A slow gentle, ease into a stretch and held most often 20 seconds to 2 minutes. This is where it is especially important to keep ROM healthy as in zero discomfort, and stretching where tissue is restricted. Utilize the inhale and exhale of your breath to find softening and ease in each position, relaxing further as you follow the breathe out. Choose to strengthen instead where joint integrity is comprimised and there is hypermobility or ligament laxity.

Book your appointment with Island Manual Osteopathic Therapies and find out more about regaining arm strength. Remember, there is no age limit or weight limit for muscle building or rehabilitation. What is most important is your attitude and autonomy. Are you able to rest when you need to and to strengthen when you can? That is all that is required to meet your own expectations for your body.

Our bodies are incredible in that they can heal themselves regardless of what we’ve been told or what we’ve told ourselves. Working with Manual Osteopathy means that the emphasis is on using the body’s own systems to maintain optimal health and equilibrium.

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