Thursday, January 5, 2012

The Triceps and Implications for Shoulder Health

For the past few months I have been working on a small theory with the triceps muscles.  I see a lot of shoulder type injuries in my office here in Grand Rapids.  Everything from frozen shoulder, rotator cuff inhibition, labral surgeries and impingement's.  One thing I've started to notice is that the long head of the triceps is weak and under developed and that the medial head has adhesion's.

Let's review a little anatomy.  The triceps brachii has three parts, hence the tri.  The bicep has two parts, hence bi.  Want bigger arms, do triceps work, 2/3 of your arm is triceps.  The triceps is made up of the lateral, medial and long head.  The lateral head, most outward portion, gives the famous horseshoe shape seen on people.  The medial portion is in the middle, and lies underneath the other two.  These two portions attach from the humerus into the ulna.  The last portion is the long head,  you guessed it,  the longest of the triceps.  It's the most medial.  What makes this muscle different is that its origin is actually into the scapulae.  All three will extend the elbow, but the long head will actually adduct the arm in a similar fashion as the latissimus dorsi.

So back to my observations.  After doing soft tissue work to the medial head, it usually brings a feeling of lightness to the shoulder or elbow joint.  I am starting to view this muscle as an upper body shock absorber, in the same fashion the vastus lateralis is a shock absorber for the lower body.  (This is why triceps strength is big time important for mountain bikers!)

Now in people that don't have shoulder issues, but do lots of overhead work, pressing, or throwing or the patients/athletes that bounce back quicker, the long head seems more well developed.  The long head may have fascial anatomy with the teres minor muscle.  It is considered part of the deep arm line in anatomy trains research. Having strong connections with the rhomboid muscle.  Functionally, the long head works to keep the under part of the shoulder joint stable.  It works to prevent displacement of the humeral head down and back.

The long head will not work in simple pressing exercises.  It is actually pretty dormant in standard pressing and overhead work.  The long head needs to be stretched to get a full workout.  Its secondary function as a humeral adductor allows it to get good work in with doing back work.  To isolate the long head, doing an exercise such as a skull crusher with combined pullover type movement, has proven to be effective.

Here is Arnold doing a famous bodybuilder pose.  The under hang is the development of the long head.  I would bet that Arnold didn't have many shoulder problems!


Matteo Corvino said...

When in the last line you say that the effectivness of skull crusher exercise with pull-over type movement has proven to be effective, it means taht there are some scientific studies on thi topic? Can you tell me which ones?

Jason Ross said...

Matteo, I will search for the research and get back to you. I can't remember where I read it at.

Matteo Corvino said...

Thank you very much and compliment for your blog: it is fantastic!!

Brian Morgan said...

Good article. I had a rotator cuff tear 20 years ago - no surgery and have done fairly well with it, aside from some occasional flair-ups. In 2004 I re-injured it, in part, with suitcase deadlifts and not being smart with progressions. I believe this was a triceps injury of the long head. Lately I've been adding in some single arm overhead triceps extensions and been doing lots of kettlebell get-ups (mostly partial) to work on shoulder stabilization and the shoulder feels pretty good. I'd heard that the long head doesn't get much work with pressing but what about the shoulder stabilization with Turkish get ups and the time under tension? What are your thoughts?

Jason Ross said...

Brian, with the TGU. You will have some isometric tension in the tricep heads, which is a good thing to train, but will not develop a complete strength curve. So keep those overhead tri extensions.

TGU are great for shoulder stability, try the Kalos Sthenos style to integrate the shoulder and opposite hip a little more dramatically.

Scott We Go said...

I would have loved to test Arnold's internal rotation in his shoulders. Is there any documentation on how often he worked on ROM and mobility?

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Anonymous said...

Hi I know Im late for this discussion but what do you think about palms up lateral raises? This exercise seems to really hit the long head tri. Also palms up front raises and anything in between the two.

Philip K. said...

Interesting topic, I'm exploring the connection of the rhombhoid muscle and biceps and triceps strength.

I believe I had major muscle spasms in the left rhombhoid muscles and when I released (some of them) I had pain relief in shoulder.
I think there is some connection between strength of the long head of the triceps and rhombhoid muscles.

That's why I'm trying to explore some of this stuff, because I'm having a triceps weakness.

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Hanna Hilton said...

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Sarah Jasson said...

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Sarah Jasson said...

This site is excellent and so is how the subject matter was explained. I also like some of the comments too. Waiting for the next post.
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Unknown said...

This makes so much sense. The past 4 weeks I’ve been nursing my left rotator cuff back to health and along the way found that my left triceps was MUCH weaker than the right. The deficiency was masked during my usual barbell lifts by the stronger right arm and also bad form habits that recruited the shoulder to pick up the slack - hence the shoulder injury.

Embarrassingly, I was too concerned with performing the rep at a respectable weight and ignored the obvious technique problems.

It has only been during the rehab period that the triceps deficiency has become clear because I’m using only dumbbells. In other words, my right arm can’t pick up the slack.

In hindsight, working with a professional early on probably would have prevented bad habits and prevented the injury. Live and learn.

Thanks for the article.

Ahne Dumalo said...

This is very informative. Thanks!

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