Wrists & Elbows – Bill Star

May 22, 2011

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In this installment I want to focus on two relatively small joints that seldom get any direct attention in a strength program: the wrists and elbows. Although the wrists and elbows play an important role in our daily lives and we use them in a vast portion of the exercises done in a strength routine, rarely are they given much consideration – that is, until they get injured. Then the reality of just how much we depend on them becomes crystal clear.

Any movement that involves the arms brings the wrists and elbows into action, which is why these two joints frequently get overworked. In fact, it’s rather difficult to come up with any physical activity that doesn’t include the wrists and elbows. Even the simplest tasks require their support. My wrist is largely responsible for the words I write on paper and is used even more when I type them. Lifting a cup of coffee to my mouth, opening a door, tugging a box of books from a high shelf, driving, bathing – the list is endless. Yet we take the movements for granted until something happens that prevents us from using our arms as we normally would. A chronically sore or injured wrist or elbow is extremely troublesome.

I’ll begin with the wrist. Severe injuries have to be dealt with right away, and they take a very long time to heal. That’s because the wrist is made up of bones, tendons, ligaments and soft tissue but very little muscle. Injuries to the attachments always take longer to recover than injuries to muscle tissue. Because the wrists take part in such a wide range of movements, from the simple to the complex, they can be dinged rather easily.

The wrist joint is a marvelous piece of work. The wrist, which connects the hand to the forearm, is made up of not one but three distinct joints – radiocarpal, intercarpal and carpometacarpal – that permit an unusual amount of hand movement. The radiocarpal joint lies between the end of the radius, which is the thicker and shorter of the two bones in the forearm; the intercarpal articulation is a gliding joint between the two rows of carpal bones; and the carpometacarpal joints lie between the carpal and metacarpal bones.

There is also a maze of cartilage, synovial sacs and bones, which work together synergistically to make the wrist function properly. And function it does. Together, the wrist joints permit abduction, adduction, circumduction, flexion and extension. The free rotation of the shoulder and radio-ulnar joints (the thinner and longer of the two forearm bones on the pinky-finger side) let the hand turn 270 degrees. Starting from the straight extended position, you can flex your wrist through from 60 to 90 degrees.

The brief anatomy lesson is to emphasize that the wrist is a complex mechanism, potentially capable of performing amazing feats yet very vulnerable because of its size.

My first injury in the weight room was a sprained wrist. It wasn’t because of my stupidity or because of faulty form. Rather, it was from faulty equipment. The Olympic bar in the downstairs weight room at the Wichita Falls, Texas, YMCA had a tendency to freeze every so often. Those who trained there knew that and took precautions. We would spin the bar a few times before doing any exercise that required it to rotate freely. It had locked up on me several times, but I was never in a precarious situation, so I just dumped it. Then one day I was doing full cleans, and as I moved into the bottom position on my third rep, the bar failed to rotate, and my left elbow jammed into my thigh. a white-hot jolt shot from my wrist to my brain. I dumped the bar and knew that I’d sprained my wrist.

That was my first encounter with a wrist problem, but I wasn’t too alarmed. I was a medical corpsman in the Air Force, and over the years I’d treated many sprained wrists. I did understand, however, that I was through cleaning for the day. Then I quickly found out that I was also through handling any more weights. There was very little I could do with a dinged wrist. Back squats were out, as were pulls, presses and dips. I ended up doing 20 minutes of ab work and left.

As soon as I got back to the hospital where I worked on Sheppard Air Force Base, I started treating my injury. I iced it, then wrapped it tightly in an elastic bandage. I followed the established procedure for icing, 20 minutes on, 20 off, and kept it snugly wrapped between sessions. There was also an ultrasound in the emergency room where I was assigned duty, and I used that a couple of times a day. The swelling subsided in a few days, and I decided to go the Y, which was my second home, and do some type of exercise. I would stay away from the weight room for a while, just so I didn’t try something foolish. I tried swimming. That didn’t work out too well, and neither did basketball because out of habit I kept bringing my left hand into the action. Finally I settled on multiple games of handball and racquetball.

The bandage wasn’t panning out either. If I wrapped my wrist too tight, it cut off circulation to my hand. If it was too loose, it was useless. So I started using trainer’s tape, which worked well. I managed to do what needed to be done in the emergency room without bothering my injury. Still, suturing, moving patients off gurneys and dealing with the floor buffer all required two hands, and I did all those tasks very deliberately. I started squeezing a ball I’d made from the trainer’s tape, which was more effective than a rubber ball or grippers. I would do that whenever I had some free time and I could tell that it was helping the wrist get stronger.

I wanted to find some way to protect the injured wrist when I started back on the weights and recalled seeing a photo of Paul Anderson wearing thick wrist straps. Leather shops abound in Texas, and I found one that was willing to design a set of strong straps to fit my small wrists. I would lock the weight down snugly with trainer’s tape, then secure it with the strap on my hurt wrist. On my healthy wrist I used tape only. I was also doing everything I could to speed healing. I dug into the reference material in the emergency room and came across a couple of ideas – soaking in Epsom salts and alternating hot and cold. I did both. I’d ice the wrist for 20 minutes, then hold it under hot water laced with Epsom salts for 10 minutes or so, then repeat the procedure.

After a week of therapy, rest and squeezing my tape ball, my wrist started feeling much stronger. Yet I remained cautious because the injury had really thrown me for a loop. Over the years I’d dinged several joints and strained a large number of muscles playing a wide range of sports, but all of those injuries had healed rather quickly – mostly because I’d been in my teens. This wrist, though, was recovering very slowly. My biggest fear was that I’d hurt it again, and I knew what that would mean.

So my first time back in the weight room was with some trepidation. When I checked to see whether I could do some exercise, I used light weights and did the movement slowly. Any sign that it was bothering my injured wrist was a signal to stop. I was able to squat and flat bench with light weights, and I could also deadlift if I kept my arms perfectly straight. I loaded the plates on the bar with extreme care after I got a shock in my hurt wrist when I didn’t pay close enough attention to that seemingly harmless move.

After another week of nursing my wrist, I decided to do more to strengthen it. I’d watched some of the wrestlers and bodybuilders doing wrist curls with a bar, and I started doing them. I was wary of using the 45-pound Olympic bar and so did wrist curls with palms up and with palms down on the smaller bar used on the lat-pull machine. I continued the hot and cold soaks and kept the hurt wrist taped around the clock, even when I slept, because soon after I’d injured it, I’d gotten up in the middle of the night to go to the bathroom and inadvertently flipped the flushing device with my left hand. A stabbing pain shot up my arm – lesson enough for me. Wrapping the wrist at night made sure I wouldn’t roll over and use my bad wrist. It also served as a reminder to be careful when I got up.

It took nearly six weeks for my wrist to become strong enough for me to go back to my normal workouts. I kept doing the strength-training exercises for my wrists and wrapping them. Indeed, it was an education on how easily small joints can get hurt and how ridiculously long it takes, even when using proper procedure, for them to get back to full strength.

Since that episode in Wichita Falls I’ve found several other excellent exercises for building wrist strength. They, like the wrist curls, are also useful in rehabbing an injury.

The very best exercise for strengthening the wrists is a simple one, and I’ve used it with great success on all the sports teams that rely heavily on wrist strength – in sports such as lacrosse, baseball, the throwing events in track and field and, of course, wrestling and Olympic weightlifting. It’s extremely important for those athletes to have strong wrists since those small joints are responsible for transferring power from the legs, hips, back, shoulders and arms up into the shot put, discus, javelin, lacrosse stick, bat and ball. A wrestler must have them in order to take control of a match. The exercise is called, quite appropriately, the wrist roller. So is the apparatus you use to perform it.

Wrist rollers are available through many weight equipment companies, but they can be built rather easily. I know because I’ve done it, and I am mechanically inept. A two-foot long section of broomstick will serve the purpose, but something with a slightly larger diameter is even better. Drill a hole through the middle and insert a length of clothesline through it. The clothesline needs to be long enough so that when you extend your arms straight out front, it touches the floor. Next, attach a weight to the end of the clothesline, and, presto! You have a wrist roller.

Use an overhand grip with the wrist roller directly in front of you at arms’ length, and roll the weight up until it touches the wood. Then SLOWLY lower it back to the floor. Both the up and down movements should be continuous and smooth. The most athletes can usually manage the first few times are two ups and two downs. That’s okay because you can add from there. Some have to start with a five-pound plate, while others are able to use a 10-pounder. The exercise must be pushed to the limit to gain the desired results. If your wrists and forearms aren’t screaming for mercy, you’re not working hard enough. The most I’ve ever seen anyone do is six consecutive ups and downs with a 10-pound plate.

When I see that an athlete’s shoulders are giving out before his wrists and forearms, I have him rest his upper arms across a bar in the power or squat rack and do wrist rollers from there. This apparatus can be used at home on nontraining days to give the wrists a bit of extra work.

I mentioned two other excellent wrist exercises earlier. Now I want to explain how to do them. You can do wrist curls with dumbells or a straight bar, with palms either up or down. Sit on the end of a bench or chair and rest your forearms across your thighs with your wrists extended beyond your knees. Grip the bar with your hands about 12” apart. If you use a dumbell, place your elbow on your thigh, and do the wrist curls between your legs.

Do as many as you can using one version, and then switch to the other for three or four sets or until you know you’ve run out of gas. When doing the palms-up version, let the bar roll down your hand until you can just barely hold it with your fingers. Then curl your fingers back until you’ve firmly gripped the bar and completed the curl.

Wrist curls are enough to strengthen your wrists, but if you like variety here’s another exercise that will bring desired results. A leverage bar can be rigged rather easily. You can use a short bar or even a three- or four-foot piece of broomstick. Attach a five- or ten-pound plate to one end. Tape will work. Hold the bar or stick by your side with the weight on the floor. Now, without moving your upper arm at all, elevate the weight until it’s vertical. Hold it for a brief second and slowly return it to the floor. The movements have to be controlled. If the weight is swinging about or being lifted in a herky-jerky manner, it won’t be effective. In fact, ugly technique can be quite stressful to your wrists and cause problems.

Then there are the grippers. If you happen to be interested in grip strength, you need to get a catalog from IronMind. It has a huge selection of grippers, from beginners to very advanced, plus wrist rollers, leverage bars, grip machines, pinch grippers and a wide assortment of other gadgets for improving grip strength. The products aren’t cheap, but they’re extremely well-crafted and are worth the money.

While the majority of wrist injuries occur during an accident, such as a fall or an athletic event, a great many happen because of faulty form in the weight room. Your wrists get stressed when they move about doing a pressing movement when they stay in an extreme flexed position with heavy weights, as in racking a heavy front squat, and when they’re twisted to the extreme. So take care to do every exercise correctly, and as a precaution always wrap your wrists when doing any movement that works them directly.

Elbow problems come about for the same reason and also from overwork. Typically, sloppy technique and overtraining happen at the same time. There are also a couple of exercises that place the elbows in a disadvantaged position and that I have on my taboo list: skull crushers and French presses. Unless you’re very advanced, these movements should not be in your program. I find no reason to do them; many others that do not place the elbows at risk are more productive.

Using a jamming motion on any exercise that involves the elbows is inviting trouble. The biggest culprit is the flat bench. Numbers take precedence over technique, and the elbows get abused. Also be aware that elbow injuries can occur even when you use light weights. I have an older friend who irritated both his elbows using just a 45-pound bar.

The elbow is made up of two joints: the elbow joint, which handles flexion and extension of the radius and ulna with respect to the humerus, or upper-arm bone; and the radio-ulnar joint, which handles pronation and supination of the forearm. Together, they act as a hinge joint and are part of any arm movement. When abused, the tendons become inflamed, resulting in classic tennis elbow. Though it may not be the most painful injury in athletics, it ranks high. When your elbow is out of commission, you suddenly find that you can no longer do a great many movements, and trying to train with an injured elbow is out of the question.

That’s why you must pay close attention when training. Use ideal technique, avoid any exercise that places undue stress on the joints, and don’t overwork. Keep in mind that the elbow is a relatively small joint and can take only so much. What most athletes don’t recognize is that the elbows play a key role in every pulling exercise, along with every pressing movement. In any program that’s a great deal of work, and I’ve watched athletes go through programs that involved the elbows on every single exercise.

Knowing which muscles and corresponding attachments are directly responsible for securing and protecting the elbow joints goes a long way toward understanding what exercises to use to keep them strong. Whenever I ask athletes that question, they invariably respond, “The biceps and triceps.” That’s half right. The biceps play a minor role. The key players are the triceps, the anconeus, which can be thought of as an extension to the triceps, the forearm muscles and the brachioradialis and brachialis, which are the two prime movers of the arm. The latter two wrap around the elbow joint and are potentially very strong muscles. Thus the greater part of stabilizing the joint falls on them.

That means you need to be doing plenty of pressing movements and lots of heavy, dynamic pulling, as the two prime movers respond favorably to those exercises. So it’s power snatches, power cleans and, even better, clean and snatch high pulls, shrugs and bentover rows. You can use much heavier weight on those lifts, and you’ll be able to overload the brachialis and brachioradialis and make them considerably stronger.

Any type of pressing movement strengthens the triceps and anconeus. Flat and incline benches, overhead presses, push presses and weighted dips are excellent for building power in the three heads of the triceps. I said earlier that I discourage athletes from doing skull crushers and French presses because they put too much stress on the elbows. In their place I recommend straight-arm pullovers and pushdowns on the lat machine, where you don’t let the bar come up any higher than the bottom of your breastbone. I really like straight-arm pullovers. You can use a great deal of weight, and it’s not the least bit stressful to the elbows because they remain straight, or almost straight, throughout the exercise. Plus, the exercise hits the long head of the triceps very directly – the only one I know of that can make that claim.

You do straight-arm pullovers as an auxiliary movement for two sets of 20. I had a host of athletes who were handling 120 pounds for the two sets. In most of my programs they’re the only specific I use for the triceps.

For anyone who wants more work on that muscle group I prescribe pushdowns on the lat machine. Those must be done smoothly and deliberately. Any jerking around will be counterproductive because it will end up irritating your elbows.

The keys to keeping your elbows strong and injury free are as follows: use perfect technique on any exercise that includes your elbows, even seemingly tame ones like curls; keep tabs on how many exercises you have in your routine that involve your elbows; and do at least a couple of exercises that strengthen the groups that support and stabilize that rather small joint. If you get an early-warning signal that you’re doing too much work or doing an exercise incorrectly, such as a slight pain at the end of a set, lower the workload on your elbows.

Other precautions will help you avoid injuring your elbows. Make sure you warm them up thoroughly before you start lifting, especially in cold weather, and make sure they stay warm throughout the workout. Sweatshirts, wraps, and muscle rubs might be in order, but they’re worth the trouble.

The same goes for the wrists. If you have a history of wrist injuries or have rather small wrists, wrap them prior to every session in the weight room. That’s particularly important if you’re planning on doing front squats, jerks or any other exercise that places a lot of pressure on your wrists. In addition, be sure to have at least one specific exercise for your wrists in your routine. You can easily do them on your nonlifting days, and not only will they help you prevent an injury but also enable you to handle more weight on a wide range of exercises.

Although your wrists and elbows might be somewhat puny compared to your other joints, they’re no less critical to success in strength training. Take care of them the best you know how. Believe me, you’ll be glad you did.

Author: Bill Star

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