Technique Of The Week

Supine Weighted Tricep Curls

What?

This is a PRI technique for scapula thoracic stabilization and spinal stabilization during elbow extension.  It is a supine technique that facilitates spinal stability, via scapula control during isometric arm strengthening.  In other words, patients with shoulder weakness, who over-activate back extensors and upper trapezius to ‘lift’ their upper extremities would benefit from this technique.  It is designed, therefore, for patients with a strong brachial chain pattern or strong overuse of ipsilateral pecs, latissimus, upper trapezius, intercostals and scalenes.  To offset these agonistic scapular internal rotators the stability of the right scapula on the thorax and the orientation of thoracic spinal rotation to the left is required.  This is offered by the right lower trapezius and the long head of the triceps.  Simultaneous, subscapularis activation, ensures humeral glenoid internal rotation (HG IR) without unwanted scapula, or glenoid, thoracic internal rotation (ST IR).  This is an early PRI intervention or positioning technique used to enhance scapula protraction, needed for upper extremity reaching and elevation, on a thorax that is guided by proper biomechanical scapula position and spinal rotation. 

Why?

The ability to move reciprocally through the thorax requires good internal and external rotation of the independent ribs and rib cage in general.  External rotation of the right rib cage is enhanced through right low trapezius and long head of the triceps.  Learning how to extend the forearm without moving the arm while placed in a position where the long head is neutral (forearm positioned in front of the chest) or where the long head is in a short position (forearm positioned in external rotation with forearm parallel with spine) reduces strain on neck, lateral and medial heads of triceps and forearm.  Proximal humeral stabilization, thoracic rib cage neutrality (reduced posterior rib hump) and rotator cuff strengthen (improved sub-scapularis function and position) are all realized.  The need for substitutional strength from the teres minor and infraspinatus during arm extension or overuse of the latissimus during pushing, reaching or extending is reduced with this technique.  The teres minor, infraspinatus, pectoralis muscle and latissimus all contribute to tricep weakness, ineffective elbow extension, posterior rib hump development and heightened upper trapezius, levator scapulae and scalene use.

When?

This technique is a good technique to use when upright thoracic orientation to the right, right humeral horizontal adduction or early upper trapezius activation precedes arm flexion coinciding with elbow extension.  Those with limited cervical axial rotation to the left would also benefit from the use of this technique.  Therefore, it is a good technique to use in early phases of rotator cuff rehabilitation, for shoulder impingement, and with patients whom have limited humeral glenoid internal rotation secondary to an over extended back.  Remember, if you wish to reduce back extension during shoulder flexion, tricep co-contraction during lower trapezius stabilization of the scapula and spine is required. 

Where?

This is a good technique to use following a right BC manual technique session.  Because of the thoracic re-orientation from the right low trapezius fiber, it becomes a good technique to use in supine for proximal humeral control (long head of biceps) during distal forearm activity (lateral and medial head).  It is the last supine technique that has the humerus in 90-degrees of flexion with elbow at a 90-degree angle.  It precedes all supine humeral 90-degree abduction or neutral horizontal abduction/adduction PRI techniques.  Therefore, it is a good technique to use before placing the long head on stretch or in 90-degrees of abduction and in a state where scapular stabilization from the long head of the tricep is reduced. 

Who?

Individuals with scoliosis, right rib humps, Type I scapulas, limited HG IR after using a manual Superior T4 technique, teres minor and infraspinatus tightness, HG superior-anterior impingement, serratus anterior weakness, and history of back extension correlated with bicipital tendonitis, would all benefit from this technique. 

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