Ep 43: Funny Bones Aren't Funny: A Guide to Elbow Mechanics

The elbow plays a critical role in daily movements and needs proper care to maintain optimal function and prevent injury.

• Three joints in the elbow allow for bending and turning palms up/down
• The ulnar nerve runs through the inside of the elbow and causes that "funny bone" sensation
• Never rest on the inside part of your elbow to avoid cubital tunnel syndrome
• Muscles that control hand and wrist movements anchor at specific points on the elbow
• Squeezing exercises with proper tools (not balls) can strengthen grip and condition tendons
• Use a hammer for rotational exercises to work pronating and supinating muscles
• Perform wrist curls with your forearm supported on your thigh for proper form
• Bicep strengthening helps with pulling motions essential for daily activities
• Tricep exercises like the Arnold press benefit both elbow and shoulder health
• Allow for proper recovery between workouts as "more is not always better"

Share your questions and experiences in the comments, and I'll provide personalized information to help with your specific situation.

Chapters

• 0:00 Introduction to Elbow Anatomy
• 2:48 Understanding the Ulnar Nerve
• 4:20 Muscle Anchors and Elbow Movement
• 6:07 Strengthening Exercises for Wrist Muscles
• 10:16 Biceps and Triceps Strengthening
• 12:00 Recovery and Exercise Balance

Transcript

Speaker 1: 0:00

Welcome back to the Hand to Shoulder Solution Giving Pain the Middle Finger. I'm your host, carl Petito. I'm an occupational therapist and a board-certified hand therapist. I specialize in the rehabilitation of orthopedic conditions that affect the fingertips through the shoulder. Now I'm really excited to talk to you about the elbow, and the elbow has to allow you to turn palm up and palm down. It has to allow you to reach yourself. It has to allow you to reach objects. The elbow has three joints involved in it. So today let's kind of shift our focus a little bit away from fixing a problem to preventing problems. Preventing problems, optimizing the health, really conditioning yourself so you don't have problems, and avoiding things that damage or injure yourself. That's wellness. So that's a proactive approach. Let's take a proactive approach today.

Speaker 1: 0:52

Brief introduction to the basic anatomy and the mechanics of the elbow itself. So, taking a look at the joints, when you have the shoulder blade lies on the back of the rib cage. Then you have the arm and the forearm, and the arm and the forearm is connected by the elbow. So on the elbow there's three joints. You have the on the thumb side, you have the radius bone which connects to the thumb side of the humerus and that bends around the end of the humerus also. Watch, this is cuts and that holds everything tight together. Then you have the tip of your elbow, so the back of the elbow. The tip is the ulna, so the ulna that doesn't spin, that is a quite a hinge on the pinky side of the hand and that comes up here. So when you touch the tip of your elbow and you follow that bone down, that's on the pinky side of the wrist. Now let's look at the forearm, because these bones you have again back to the radius. On the thumb side you have the ulna on the little finger side and when you turn your hand palm up, your radius is now parallel with your ulna. When you turn it palm down, the radius flips over the top of the almond. You see the action of the motion at the elbow and there's motion at the wrist also. This is going to be very key information when we talk about the strengthening. So have an awareness that there are three joints inside the elbow.

Speaker 1: 2:39

Now there are nerves which connect to your muscles and nerves also give a sensation. So anytime you pinch off a nerve, the yellow portion are the nerves. So I want to bring your attention to what's called the ulnar nerve. So on the pinky side, if you feel this bony knob on the inside part of your elbow, sometimes it's best to start by touching the very tip of your elbow and then come up and you'll feel the bony knob on the inside. Between those two is a trough. It's a little ditch that you can feel and it's soft and that's where the ulnar nerve lives. And the nerve is larger than what it shows on the model. It's about as wide as a pencil or a pen and thick like a noodle. When you hit your funny bone you're hitting the nerve, so it's not the bone at all. When you bump that, you get a zinger down the pinky side and you're actually hitting the nerve. Now that's why that we should never rest on the table, we should never rest on the armrest. I talk about this syndrome. It's called cubital tunnel syndrome. I talk about this in other videos and pressure on the nerve is what causes the numbness and the tingling and the aching causes a lot of severe problems.

Speaker 1: 3:58

It's very crucial to stay off of that inside part of the elbow. You know, the general rule is to just always, 100% of the time, avoid any leaning, any resting on the inside part of the elbow. Avoid any leaning, any resting on the inside part of the elbow. Okay, the fingers and the wrist, they are attached at the end of this long the upper arm bone, the humerus. So on the thumb side, there's a knobby area right here and that's the anchor point to the muscles that do this and the muscles that do this and one muscle that does this. So there has to be an anchor point, because muscles only pull, they don't push. So when the muscles pull, when you, when you activate certain muscles, they'll do certain things and that's where they're tied in. Now, on the inside part of the elbow, you'll feel a bony knob right there and that's the anchor point to the muscles that do this toward your palm, the muscles that grip and the muscles in one muscle that turns it palm down.

Speaker 1: 5:06

So here's an interesting thing. So when you're squeezing something really hard, I'm gonna grab this hand grip. So when you're squeezing something really hard, I'm gonna grab this hand grip strengthener. And you're grabbing things, you're holding hammers, you're pounding. When you're squeezing hard, you're using these muscles right in here that are anchored up here and you're also stabilizing with the opposite side. So when you squeeze in order for this not to happen, your wrist muscles over here have to contract to keep you straight.

Speaker 1: 5:34

So if, if you have tennis elbow, if you have a lot of pain on the outside part of your elbow, you're squeezing, say, well, wait a minute, I'm using these muscles when I squeeze. That is going to also activate this and to keep your wrist straight while you are squeezing. So squeezing is a good exercise to do, whether it be you know something like this or another device which is similar to the other one I just showed you that has springs, but not a ball. A ball is unhealthy for the hand. Everybody wants to squeeze a ball. Our hand is sort of cuffed like that, but squeezing a ball is not good for you to do. So squeezing and something you know if a person has arthritis. I have them do isometric just to hold, so they're not doing a lot of different repetitions in aggravating the joints. Now, when you squeeze and hold, you're working these muscles and getting yourself conditioned to handle the heavy work, the heavy you know weight, other weight lifting, other things that you want to do in your life but some tension or some tensile stress on the tendons where they connect to the bone and it makes them thicker and stronger. Now, if you're already having pain, you have to be seen by your healthcare provider, because trying to do conditioning is going to make your whatever condition that is causing your pain. It's going to make it worse more often than not. So, again, we're talking about conditioning. We're talking about a proactive wellness approach.

Speaker 1: 7:08

Talked about muscles that turn your hand, palm up and palm down. A great exercise is to use a hammer, because you can adjust the resistance. So obviously, this is less resistance. This is more resistance when you are squeezing the hammer using those muscles that I just showed you. When you turn it palm up, you're working the muscles. From this position, you're working the muscles that turn it palm up, you're working the muscles. And from this position, you're working the muscles that turn it palm up. You're working the muscles that do this and you're working a grip. When you turn it palm down, you're working the grip. Again, the muscles that turn a palm down and the muscles that do this the muscles that move your wrist, the ones that bring it up toward your palm or in the palm or surface, the ones that bring your hand up toward the back of your hand are on the side, that's, in line with the back of your hand. So I'm going to demonstrate a couple of nice wrist exercises to strengthen your wrist and the best positioning so you avoid injury and you get these muscles nice and strong. And when I bring it up here like that, you can see it work and they're anchored in again to the outside part of that bone on the end of the humerus. That's right there and, by the way, if you touch that, the outside part right here and that's really tender, chances are you have tennis elbow and you really really should get looked at.

Speaker 1: 8:31

So now let's go to the dumbbell. So, working the muscle, lie your forearm, the palmer surface of your forearm, on your knee and I like to come up on my toes just a little bit and then I get this. The dumbbell, and it's at my arm, is at a little bit of a downward angle and then slowly do some curls. Now your wrist is not oftentimes not going to be purely straight up and down, it might go at a little bit of an angle. If it wants to go on a little bit of an angle, allow it to. So you can go here and you know you should use enough weight so that you're pretty tired after the 12th, 15th repetition.

Speaker 1: 9:12

You know, 10 to 12 reps, typically for endurance and strengthening For the muscles on the opposite side. It's nice to get on the inside part of your thigh, just above your knee, so you can get here and then again you're down at a little bit of an angle and then you're going to curl that up like that and you can see the tendons right here that connect the hand and wrist to the muscle and then this is anchored in on the inside part of your elbow. So strengthening all of this is great for the elbow and then also the muscles up here that bend your elbow. Some are connected to actually to the socket of the ball and socket. All right, continuing on with strengthening, from the hammer curl position you can go straight up like this I like to get my arm right in here on the inside of my thigh and come up and that's working brachialis and biceps.

Speaker 1: 10:21

So brachialis lives underneath the biceps and another nice technique is to maybe start in a hammer position. Then, as you turn a palm up, you're working biceps and then you're also working brachialis. So those slow, steady techniques are very, very good for the muscles that bend your elbow and the flexors, the ones that bend your elbow. They're called the flexors. They pull things into you and they save your life. You can pull yourself up and save your life. You can. You can you bring food into you? Now? Shoulders the one of the healthiest things to do for the shoulder. One of the best exercises and this also works the triceps is to just push it straight up and as you push it up, the dumbbell rotates and that's called arnold. Press your back and you're really isolating those triceps. And the triceps, the ones that straighten your elbow. I'll show you here on the model. They connect to the tip of the elbow so when they contract they straight. They straighten your elbow.

Speaker 1: 11:36

So that's a brief introduction to some of the considerations of strengthening. You know why it's important. Some of the best exercises you know, always listen to your body. If it's sore, let's say you did a lot of work that day and you're just. You know your muscles are a little bit sore, your joints are a little bit sore. Don't do strengthening. Save it for another day, after you've recovered for a bit. And a person should strengthen, you know. Go to the gym two days a week, three days a week.

Speaker 1: 12:03

The recovery period is very important. Work different sets of muscles. Allow the other sets of muscles that you worked the previous day, allow them to recover and alternate Rotate exercises so you don't wear yourself out. More is not always better. The body is living, you know, sort of like a plant. You don't want to water the plant every single day or all day. Every day there has to be a recovery period. Thank you for watching, thank you for subscribing. Write in some questions. Write in some comments. Share your experiences. You really I like questions because you know I I can really give you some pinpointed, uh, accurate information and share this information with other people who might be wondering, you know, might be having the same questions as you. Thank you.