The next muscle we will consider is the triceps. This muscle forms the bulk of the posterior upper arm and is an extensor muscle for the elbow joint and one of the shoulder joint extensors.
As the name suggests, this muscle originates with 3 heads- the long head (which starts from the infra- glenoid tubercle of the scapula) and the medial and lateral heads which originates from the posterior surface of the humerus. The three heads form a muscle belly and insert via a common tendon into the olecranon process of the ulna and the elbow joint capsule. The triceps muscle is an elbow joint extensor. The long head of triceps contributes to shoulder extension and adduction.
The triceps is one muscle of the arm which is strengthened and hypertrophies when workouts target triceps such as push-ups, press downs, bench presses, bench dips, overhead extensions. However, it is important to maintain healthy length and flexibility of the muscle, and stretches for triceps should be incorporated in the exercise program.
This may be done via manual techniques and release of trigger points along the triceps by a physical therapist. Passive manual stretching may be done in supine position by flexing the elbow joint completely with palm facing up. Once the forearm muscle bulk approximates the upper arm muscle bulk, stabilize the scapula downward and into the rib cage with one hand, while the other flexes the upper arm at shoulder with the elbow in flexed position as far as possible and hold for 5-30 seconds. It is important to keep the spine neutral and not extend the thoracic spine. Release by lowering upper arm and extending elbow to neutral. Repeat stretch 2-3 times.
Active Static Stretch
i) Initially this stretch is best done in supine as it eliminates need to stabilize the trunk and scapula as it is well supported on the mat. Similar to above passive technique, first begin by actively flexing the elbow with palm facing up. Next, flex the shoulder as far as possible while maintaining neutral thoracic spine. Stop the shoulder flexion as soon as you notice tilting of shoulder blade and mid to low thoracic spine arches upwards into extension. Hold the position and stabilize spine by activating transverse abdominals. See if you are able to flex the shoulder overhead a little further and hold for 5-30 seconds. With good flexibility, you should be able to slide the palm between the shoulder blades. Release and repeat 2-3 times.
ii) With good scapula-thoracic and lumbar spine stabilization, this stretch may be done in seated or standing position. Sit upright in a chair without back support or stand with feet hip width apart and maintain neutral spine. First stabilize the spine through trunk corset activation (transverse abdominals, multifidi, and obliques) by 2-3 breathing cycles. Trunk and spine should be steady with no movement with inhalation/exhalation and notice movement of rib cage and abdomen only. Next, flex the right arm at elbow, and cup the shoulder with the hand. The upper arm is still in line with the trunk. Next, flex and elevate the arm at shoulder joint to overhead position and slide hand between shoulder blades, if possible. Stretch may be deepened by bringing the left hand to the right elbow and gently pulling right arm back and to left. Hold position for 5-30 seconds. Release and repeat 2-3 times.
Active Dynamic Stretch:
i) Gomukhasana: This is an advanced yoga pose and must be done with proper guidance. The starting position is Vajrasana. Initially come to sitting on the right side, with both feet pointing left. Keeping the legs bent at the knees, rotate the left hip outwards as you stack the left knee on top of the right so that you are now sitting on both the sit bones. The feet are resting on the floor. Bring the heels as close to the hips as possible. Trunk is stable in upright position. The left arm is rotated inward at the shoulder while bending the elbow and the back of the hand is placed between the shoulder blades from below. The right arm is rotated outwards at the shoulder while bending the elbow and the arm is lifted overhead placing the palm between the shoulder blades from above. Once the two hands are behind the back, the triceps stretch on the right side may be deepened by interlocking the fingers of both hands in hook grip behind the back and gently pulling downwards with the left hand. Trunk needs to be stabilized further as the pose is deepened, to prevent the thoracic spine from arching.
Stretching with tools
i) One may use a tennis ball for releasing the triceps brachii by placing it between the back of upper arm and wall or on a table and release trigger points by simply holding the pressure for few seconds and moving to a different point along the muscle. It may help to first palpate the muscle belly with the finger pads prior to employing the tennis ball to determine the areas needing release. Rolling the ball gently between the back of the upper arm and wall/table, is another way to identify trigger points and release by focusing rolling (small circles or up and down) over tender points.
(P.S: Anatomy picture from Wikimedia commons)
By CFCF (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons
Ami Gandhi is a licensed physical therapist in the state of California. She is the owner of StableMovement Physical Therapy, a small boutique practice in San Jose that offers patient centered, one-on-one, hands-on physical therapy.