Sebastian Brosche · 7 min · 1,224 words
Sports physio Joel Kreska's go-to drills to get elbow rotation and flexion back after armbars and basing injuries.
Hey there, it's Joel Kriska, sport physiotherapist, back here again. We're going to today look at some rehab tips for elbow injuries, which is fairly common in jiu-jitsu, whether you are getting them from being armbarred or for basing out on an arm. I've actually had two colleagues that dislocated their elbows recently and that is a catastrophic injury to come back from to do in jiu-jitsu. One of the key things that has to happen with recovering from elbow injuries is we have to make sure that we get this rotational motion of the elbow back.
Everyone focuses on this sort of flexion extension motion, which is going to come for the most part. Often people will be a little bit limited in flexion, which can be a problem when you're trying to get people off you or you're trying to get into some deep movements in yoga. One of them that people always forget about is this lack of rotation, particularly going palm up towards palm down. It's absolutely vital, one, because if I don't go palm down all the way and I'm trying to do that, inevitably my forearms are going to go palm down, but notice my elbow is going to flare to make up for that difference.
So again, what you'll see in a lot of people is they think they're doing pretty good, they're working on their computer and they're doing this all day long. This is going to stress their shoulder more so, and it also trains you that while you're doing jiu-jitsu, you're going to go palm down motion and notice I'm flaring my elbow. This creates a space for either people to get in here and attack or, and truth be told, I mean, again, remember, elbows to your side is a stronger position and anytime my elbows are away from my body, my shoulders are at a disadvantage. The other problem that we have with a lack of pronation range of motion going palm down is that typically what you'll see, especially after an injury, is that if I'm stiff going palm down, I'm going to be way weaker turning palm up, and that's important because that is the rotator cuff of the elbow, and we've seen that kind of issue in the knee where we have a lack of rotation control in the knee that can cause some issues.
In the elbow, it's even more so because it's the anchor for all the muscles that come from our hand, i.e. gripping muscles. If we have an injury or you just notice that I'm actually someone who's a little bit stiff and to go in palm down, the first thing we want to try and do is encourage movement going palm down, and we're going to overpressure using our other hand. What you're going to do is with your other hand, we're going to keep our thumb beside our other fingers.
We're not grabbing like a C grip like this. We're keeping it tucked in with our other fingers, and we're going to come over and grab over the top like this. We're going to not grab at the hand because the hand can sort of make up some extra motion. Like I'll show you here, if I keep my hand still, I can still wiggle my elbow around, or if I grab my wrist, I can wiggle my hand around.
What I want to do is I want to grab a little bit just above the crease of the wrist with my fingers being all stuck together, right at the palm here. This is going to sit right on the radial head. I come over like this, and I'm going to give it a nice firm grab like this, keep my elbow pinned, and I'm going to do a motorcycle throttle, and we're going to hold it down. If you look at where my thumb is positioned here, for me, this is where I sit normally, and I can bring it down to about maybe 20 degrees of rotation into extra pronation, and a little bit more flexible than some people.
Other people, they might be sitting sort of at this angular motion here. Your goal is to get it so it's sitting perfectly horizontal. We just again pull down and hold that throttle, hold it for maybe five, 10 seconds, and then ease out. Eventually that will come.
The second part of this whole thing is, again, we've got some new space, now we want to occupy with some strength and control. Always. Anytime you get more range, you want to occupy it with more strength and control. We're going to grab some resistance tubing, and what we want to try and do is, again, we're going to elbow squeeze, and now we're going to rotate outwards, so going palm down towards palm up.
This is absolutely important that you are pivoting on your pinky so that we're lengthening the resistance. We're rotating at the elbow, pivoting around the pinky. We're not pivoting around the thumb. Yes, you're still rotating, but this is no resistance whatsoever, and we're trying to challenge the rotator cuff of the elbow.
What we're going to do here, we keep our elbow at our side, pinky on our knee, and then we're going to roll around the pinky back and forth. Our goal here is to try and get 50 to 20 repetitions. Great. As it gets easier, rather than going a heavier resistance band, I want you to try and think about, okay, this is fairly easy, and this is fairly hard with straight arms.
We're going to slowly winch our way progressively to straighter and straighter elbows as we do that same motion. On week one, I might start with bent elbows. On week two, I might get to about a 45 degree lack of full extension, and then the third week I might get to full straight elbows. Nothing changes.
When I'm straight elbow, my shoulder doesn't move. The pivot or the rotation only happens at the elbow. It's really hard to see on camera, but the motion is only happening from here down, and I'm still pivoting on my pinky. Okay?
Again, when we think about these motions, notice that fetal position, everything is nice and tight and safe, so shoulders, whether down by my side, are much easier. When they're up here, they're exponentially harder. When my elbow is tucked in nice and bent like this, it's very safe. I've got the use of other muscles, and when it's fully straight, it's more compromised.
When we're in positions like going back to sport and we're getting arm barred, this is actually the dangerous position, and then we're going to start to do things like the hitchhiker escape and stuff like that, which uses that supination moment. But again, if we're only strong here, and then we're not strong when the elbow is straight, and then we're going to attempt to try and use some resisted supination or that hitchhiker motion, you're going to get caught again, and you're going to hurt your elbow again. So really take your time working through these. I hope this has helped, and I hope to see you on the mat soon.
Have a good one. Thanks.
This is the transcript. Become a member to watch the video.
Watch now →.avif)