0:04 This is Brent of the Brookbush Institute, and in this video we're doing forearm 0:08 exercises for those exhibiting forearm dysfunction. That would be issues with the 0:12 wrist, or forearm, or elbow. I'm going to have my friend Crystal come out,, she's 0:16 going to help me demonstrate flexor activation. Now all of these exercises 0:22 for the forearm are fairly simple, and fairly simple to mess up. So we need to 0:27 be very careful with the devils and the details of these exercises. Now we 0:33 know that forearm dysfunction involves excessive pronation, ulnar deviation, and 0:38 extension, right it's that typing position essentially. So what we want to do is try 0:43 to get out of that extended position by strengthening our flexors. The detail 0:48 comes in, is when we strengthen the flexors we have to make sure we're not 0:51 going into flexion and ulnar deviation, because that's going to strengthen our 0:56 flexors sure, but into the compensation we're trying to get out of. So what 1:02 you're going to use is this FlexBar here. These are the FlexBars from 1:05 Theraband, they come in a bunch of colors and strengths. They're not that 1:08 expensive so it's easy to give these for home exercise programs. Now the 1:13 difference with this particular exercise is the side that you're working on 1:17 actually goes on the bottom, and then your top hand is going to be an anchor 1:22 for the FlexBar for you to twist against. Now if I just asked her to twist 1:28 the FlexBar, yes--that's flexion, so this way, and I have 1:34 a feeling that if I just ask her to to do flexion, she's already doing it. You 1:38 can see how she's going into this ulnar deviation, how she's breaking at the 1:42 wrist here, down. We need to figure out a way to get her to stop doing that, and 1:47 then we can actually also add a trick here to increase the range of motion of 1:52 this exercise. The trick first for ulnar deviation is -if you guys get them to 1:58 think about putting this little part of their wrist, this indentation right 2:03 above the styloid process of their ulna; if they think about keeping 2:08 that down on the table, and you don't have to like crush the table, just 2:13 so that's touching. It's actually impossible for them to 2:18 keep that touching during the exercise and ulnar deviate. And so I want you to 2:23 flex but keep that down. You guys can see already now she's not breaking at the 2:30 wrist and going into ulnar deviation, because if she does that would lift that 2:34 little divot just above the styloid process off the table. You can see 2:40 now she's all of a sudden pursed lips, all of a sudden this exercise just went from 2:43 oh yeah this is easy, to i got to think about what I'm doing. 2:47 You'll see a lot of tongues sticking out too, like people try to figure out how to 2:52 get their wrist to move that way. Like I said not hard, devils in the details 2:56 though. Now the other trick I can do just to get her a little bit more range of 3:01 motion because sometimes it does feel a little limiting to just kind of only go 3:05 into flexion from neutral, is we can actually have you go into flexion from 3:09 an extended position right. It really gets you a little bit more strengthening, 3:13 and all you have to do is is kind of start back like this. Start in that 3:17 extended position, make sure that little divot above the wrist is down, reposition 3:22 this hand and hold, and then go ahead and go into flexion. Of course it's going to 3:27 make that a lot harder too, because as she gets into end range flexion she's going 3:31 to have twisted this FlexBar up a lot more. How does that feel? Tough, We'll do that 2-2-4 3:39 count, or i'm sorry 4-2-2 count, so two-second concentric two-second 3:45 hold, and then two, three, four second eccentric that we use for activation 3:51 exercises. I'd want her to do 12 to 20 reps, assuming that she could do 12 to 20 reps 3:58 with at least the lightest FlexBar pain free. Of course if she started feeling pain 4:02 I would just have her stop there for today. We can do these exercises daily or 4:08 twice a day, and given the position she's in, this is really easy stuff to do with 4:13 a desk, so it's great home exercise. If she could do, at your desk yeah, or well I 4:19 guess it's not home exercise anymore it's work exercise. Okay it's 4:24 a work exercise program, we're making up new terms now. 4:28 But you guys can go up to heavier FlexBars as they get stronger, and 4:37 I'd expect somebody's flexion strength to be able to get pretty strong, 4:40 even with all these cues of starting in an extended position, making sure they 4:46 stay out of ulnar deviation. And we want to make sure that they stay out of ulnar 4:53 deviation because we don't want synergistic dominance of our ulnaris 4:57 muscles, that would be like our extensor carpi ulnaris and our flexor carpi ulnaris 5:01 muscles. That's a little harder here, this might be a little 5:16 rough. Yeah probably not going to happen through full range, but at least now we 5:23 kind of know that the red one works. The yellow one looked a little too light, 5:27 blue ones a little too heavy. Okay I can send her home with the red FlexBar and 5:31 she can work on that this week, and then we can move up on to the next level the 5:35 next time she comes in. There is a progression of this flexion exercise 5:39 which is called a reverse Tyler twist, which we're going to talk about in our next 5:43 video. But I'm going to go ahead and make the point that you should probably do 5:47 this exercise first, for no other reason than teaching the cue of staying out of 5:53 ulnar deviation. Once I show you guys that Tyler twist video I think you'll 5:57 realize that there's no easy way to cue somebody out of that once they get to 6:01 that progression, so this is a really good foundational exercise to start 6:06 teaching proper wrist mechanics during these exercises. I hope you enjoyed this 6:12 video. I hope you guys get great outcomes with these techniques, feel free to leave 6:16 comments and questions below. 6:25 you
