Forearms 101

Daydreaming in jr. high social studies class I used to admire my forearms, thinking I would make a pretty good body builder. At the time I thought I had some nice muscle definition. Clearly I was just a dorky jr. high kid. Right after this phase I wanted to be an accountant and look where I am now – the burly forearms won!?

In honor of well-defined forearm muscles everywhere and my former daydreaming days, I humbly submit to you, dear reader, this primer on the forearms. Forearms house the bulk of muscles that work our hands and fingers. If all of our hand muscles were in our hands, each hand would be about the size of a catcher’s mitt. Although there are some fancy specialized muscles, the forearms are pretty straight forward. The flexors on one side flex the fingers and wrist (think curling in the fingers and wrist). The extensors on the other side extend the fingers and wrist (think of a police officer directing traffic showing “STOP” with her outstretched hand) (Or think of the Supremes’ hit “Stop in the Name of Love” and feel the Motown wave washing over you!).

There are other muscles that help us perform all the exact motions that make our arms and hands so amazing, but I’m just going to focus on flexors and extensors today.

Why even write about the forearms? Don’t they kind of take care of themselves? When people come in for massage they want to focus time on massage for the weary back and neck. But wait! When I get to the forearms I often hear, “I didn’t realize my arms were so sore.” Yes, they work hard for us and we want to take care of them.

Muscle mapquest: see the photos above. The Trail Guide to the Body by Andrew Biel (Books of Discovery 2005) describes the forearms this way: “As a group [the extensors of the wrist and hand] are smaller and more sinewy than the forearm flexors.” p. 143 “…the flexors are thicker and more pliable than the extensors.” p. 148 It may be obvious, but these muscle groups are antagonists to each other. When one side is working, the other side is not. Ideally there should be balance in the strength between the 2 groups.

Why should I care, Susan? I argue that many of us use these forearm muscles more than we realize. And we often overburden them without realizing it. Further we pay them no heed unless they really complain, which is often a little late for their health. Tasks like typing & mousing use these muscles repetitively. Activities like playing piano, drums, violin, guitar and many other instruments tax them.  Racquet sports like tennis & racquetball give them quite a workout. Any activities where you are gripping an object repetitively or with a lot of exertion will use these muscles. Rock climbing comes to mind too! Ever heard of carpal tunnel syndrome? Well that has a lot to do with how we use these muscles because the tendons to these muscles dive under the flexor retinaculm and can cause inflammation in that carpel tunnel. See the quote at the end for more information.

Here are 3 strategies for taking care of these workhorses of daily living. They can be used together or separately.

Ice bath: On days when you are really giving your forearm muscles a challenge, you can treat them to an ice bath. To do so, fill up your kitchen sink with cold water. Add a couple trays of ice cubes. Dip your arms into the water up to and including the elbows. Keep your arms in for as long as you can tolerate the cold. Raise your arms out of the water and let them warm up or dry them off. Dip again several times. This takes down inflammation caused by repetitive use. It also flushes blood through the muscles by alternately constricting and dilating the blood vessels in the area.

Self massage: These muscles are fairly easy to massage oneself. Lay 1 arm flat on a counter, desktop or tabletop. Apply a small amount of lotion so you can glide over the muscles. With your other hand shaped like a fist, apply pressure with the back of the knuckles as you slide from wrist to elbow. For extra benefit alternate between making a fist and stretching the wrist and fingers back of the arm being massaged while you slide up with the working hand. Start on the more fleshy flexor side and then change to the extensor side. You’ll find it’s a little more bony on the extensor side, but feels fabulous.

Helpful tools: There are several helpful tools on the market that can help you take care of your arms. Here are 3 of my favorites: Roleo, Armaid, The Stick. If you want to purchase the Roleo through Gaiam or The Stick, click on my affiliate link first over at Foothill Health Dialogues. I’ll get a little kick-back that helps pay for maintaining that site. (Thanks!)

Here’s what one of my favorite authors has to say on the topic:

Median nerve entrapment, especially in the carpel tunnel, is one of the most common upper-extremity injuries. While the carpal tunnel is the likely site for median nerve entrapment, there are at least half a dozen potential sites of nerve entrapment between the neck and hand. In many cases, a carpal tunnel syndrome becomes more symptomatic than it normally would because there is at least one additional location of nerve compromise along the median nerve’s path. Even a partial nerve entrapment can complicate the condition.

Traditional treatments for carpal tunnel syndrome often only focus attention on the carpal tunnel itself at the base of the hand. The contribution of nerve entrapments in other locations can be overlooked. An advantage of massage therapy treatment is the amount of time the practitioner spends with the client and the subsequent thoroughness of soft-tissue treatment that can be applied throughout the entire upper extremity. Extensive massage treatment along the entire path of the median nerve helps make sure any of these potential sites of nerve entrapment are properly neutralized. Orthopedic Massage Theory and Technique by Whitney Lowe (Mosby Elsevier 2009) page 270.

Incidentally I think my 8 year old son would think I’m extra cool if I told him I was “neutralizing” the enemy of carpal tunnel syndrome. What do you think?

Lastly, please remember I’m not a doctor and this is not medical advice to you personally. Especially if you believe you have some forearms challenges, please get them checked out by a physician, physical therapist or another healthcare professional.


One little change – using a book stand

Is reading a physically taxing endeavor? Most people would say no. However, many of the graduate school students I know are inclined to say “yes” as the years of heavy reading inflict damage on their bodies. I dedicate this post to all my grad student readers. May you survive the volumes of reading with health & happiness!

One little change can make reading an easier task on your body: using a reading stand to prop the book at an angle that’s easier on the neck. I’ve taken some photos of me reading. When you look at the pictures, pay particular attention to the angle of the neck.


In photo 1, my head is comfortably balanced on top of my spine. My head tends to be forward of optimal posture (true confession!), but this is a pretty neutral position given that underlying issue. Another thing I like about photo 1 is that my hands and arms are free to be in any comfortable position since the book stand is holding the book for me. That’s one less task during the day where my hands & arms need to be forward of centerline, my shoulder blades can be back on the back where they should be and my rib cage can be balanced in the center plane. (P.S. I love my IKEA chair – very nice support!)

Let’s take a look at photo 2. My head is farther forward over my rib cage, shoulder blades creeping off the back toward the front (technically called protraction), hands & arms engaged in the task of holding the book, feet or legs more likely to be crossed to achieve overall balance (not shown). This posture seems benign until you do it for hours. You would usually feel the long-term effects of this posture as strain in the upper back and neck muscles.

And finally photo 3. I look comfy on the couch, don’t I? However, my neck is at a severe angle, flexed forward. Shoulders are all akimbo. My left arm is supporting a lot of weight. If we had X-ray vision, we would see my spine is contorted laterally. I wouldn’t last long in this position. Mind you, changing positions often can be good for gobs of reading, but another strategy is to find a posture-neutral or posture-supportive position and then take movement breaks where you truly engage your body in a range of motion for a body “snack break.” Perhaps pick up a hula hoop during your reading break or do the limbo to some groovy music.

A book stand can be as simple as a plastic cookbook stand (photo 1). There are also products for sale like this from Amazon. (By the way, if you think you might want to buy something like this from Amazon, or any other product from Amazon, consider clicking over to my community health blog and starting with a click on my Amazon carousel. If you make a purchase, I’ll get a little kick-back which helps offset the cost of running that blog. Thanks!)

I’ll end with a quote from Family Circle’s March 2009 issue which got me thinking about this topic years ago. “‘Slumping in a chair crowds your internal organs, resulting in sluggish digestion that can lead to weight gain,’ says celebrity Pilates instructor Brooke Siler. Make sure to keep your waist long by imagining there’s a vertical toothpick in the space between the bottom of your ribs and the top of your hips.” Toothpicks also available on Amazon!?!

Hot & cold

If you’ve been a client of mine for any length of time you’ve probably heard me share one of my favorite tricks for loosening up tight muscles. The use of heat and ice can do wonders for overworked muscles. Hot packs and ice packs are relatively cheap. The only other things you need are some time and common sense. Here’s how it works for the neck/shoulder muscles.

Find something you can heat like this crescent-shaped neck wrap. The kind I like best is sold here. You don’t have to be fancy, though. Filling a tube sock with rice can work great also. Place it around your neck and leave it there for about 12-15 minutes or until you feel it cool down. If you purchase a product, it will come with heating directions. If you’re using rice in a sock, heat in the microwave in 30 seconds increments until it’s hot. Be careful you don’t get your heat pack so hot it burns you (this is the common sense ingredient).

The heat dilates the blood vessels in the area, bringing fresh, oxygenated blood to the tired, overworked muscles. The fresh blood brings nutrients to the area and whisks away waste products. Next, you’ll switch to cold, which constricts the blood vessels. In the end you’ll want to alternate between hot and cold 3-5 times for maximum benefit. The dilating and constricting of the blood vessels manually pumps blood through the area, reviving it and restoring health to the tissue.

Ice packs come in all shapes and sizes. Here I’m modeling a long, flexible ice pack. Since it doesn’t wrap around the neck, I’m holding it, which is not ideal. I like to use smaller flexible ice packs and sit back in a comfortable chair or lie down so that the ice pack stays in place. Be careful to place something between your skin and the ice or ice pack so that you don’t get a burn. Again, fanciness is not required. Packs of frozen peas work really well too. Have the ice in place for 8-12 minutes.

In this post I’m showing neck/shoulder care, but the same strategy can work for any muscle group. You can also add some massage after the heat segments to loosen up the muscles more. You can do this yourself or have someone massage the targeted muscles. An additional benefit of the heat is that is softens the connective tissue surrounding the muscles and makes the area more pliable.

Write to me if you have any questions. Remember the common sense piece. And, lastly, I’m not a doctor; this is not medical advice; you may employ this self-care strategy at your own risk. Thanks for reading!