0:04 This is Brent of the Brookbush Institute, and in this video we're doing more exercise 0:07 for those exhibiting forearm dysfunction. In this particular video we're going to 0:11 do an exercise called the reverse Tyler twist, which is particularly 0:15 effective for eccentric strengthening of the flexors. I'm going to have my friend 0:20 Crystal come out, she's going to help me demonstrate. Now we know that in this 0:24 postural dysfunction of the forearm we end up with too much pronation, ulnar 0:28 deviation and extension. So I'm giving you more flexion type exercises here. Now 0:35 we already did one video that introduced flexion and worked on keeping out ulnar 0:40 deviation. I still recommend that as a starting point before this particular 0:45 exercise. This exercise we would use to start really increasing the amount of 0:51 strength, the amount of resistance that we're using. I'm still going to have you 0:55 start off pretty light, just until we get this exercise. We are going to be doing a 0:59 little like crazy hand thing which is a little confusing up front, but once you 1:05 get it, it's a pretty effective exercise I think you guys will really enjoy it. So 1:11 we're going to do this hand, I'm going to mirror you. So you're going to put this 1:15 hand on top, we're going to say this is your effected side, this is the side we 1:18 want to work on. What you're going to end up doing, alright so this hand goes like 1:25 this. You're going to turn all the way into flexion, and then anchor down here, 1:32 so let's squeeze nice and hard,and then all you have to do is try to maintain 1:37 this flexion as you straighten out your wrists.Perfect, stay right there. 1:41 Now from here we're going to eccentrically strengthen these muscles 1:46 right here, by slowly letting off tension with this hand. Great, that's it. 1:57 Can you do it again? Yeah let's try it. Alright, so notice her hand is all the 2:03 way turned in, so she starts off flexed, she anchors down, and then tries to 2:11 keep that flexion as she straightens out her arm, so that she starts in a flexed 2:16 position and essentially is only doing eccentric 2:20 contractions. We do have some research to show that eccentric strengthening may be 2:27 particularly effective for things like tendonitis. So when we're dealing with 2:31 medial or lateral epicondylitis, golfer's elbow, tennis elbow. The reason I like 2:39 this exercise is this focus on eccentric strengthening, and this little maneuver 2:45 we're doing which admittedly takes some practice, and you need to set some time 2:50 aside with your patients because it's going to take a second to teach, is you 2:56 can ramp the resistance up on this pretty quick though. I'm guessing that's 3:00 pretty easy for you Crystal. You think you could do 20 reps no problem? All 3:07 right show me how you set this up. So notice how her knuckles are 3:14 pointing right to me. She's going to start with it close to her chest and her 3:18 knuckles are pointing towards me, she's going to try to keep this flexed 3:21 position, straighten out her arms, she's in that flexed position, now she 3:24 just slowly lets off tension. Is that heavy enough? Yeah are you sure? I mean I 3:33 I think the big blue, do it. Guys these are just a FlexBars, I know I've mentioned 3:41 in a couple of our other videos but these are the FlexBars from Theraband. 3:44 They are the best tool I've seen for this stuff, little tough huh? Oh yeah, yeah 3:52 the blue one is really really tough. Make sure when you guys buy these for your 3:56 your clinic, or your office or your gym, that you do buy a whole set, because the 4:02 blue would be a little unfair if we weren't dealing with Crystal 4:06 and her massive arms, or a little bit larger individual. The yellow and red I 4:12 tend to use a lot more often. You know somebody who doesn't work out a whole 4:18 lot, their grip strength is not used to like massive amounts of weight. Obviously 4:24 somebody with resistance training experience who's used to carrying around 4:27 dumbbells, will probably have a little stronger grip strength. Is tha beginning to 4:32 get hard? Alright guys so this is the reverse 4:35 Tyler twist, like I said I would use it as a progression from that flexor 4:42 activation we taught, where we kept this little groove right here above our ulnar 4:46 styloid process on the table. We want to do that one first so that we teach 4:51 people to stay out of ulnar deviation. After they mastered that, I would then 4:56 switch to something like this, so that I could start really ramping up resistance 5:01 and really gaining that functional strength back for flexion, and somebody 5:07 especially in somebody who has had some long-term dysfunction, and maybe some 5:10 weakening. Guys I hope you really enjoyed this exercise. I hope you have fun trying 5:15 to teach people how to do this little confusing hand position thing, have fun 5:20 with it, make fun of yourself. It'll make things go a lot smoother it's great for 5:25 home exercise programs. Obviously it can be done obviously at somebody's desk too, 5:29 which is really nice. If you guys have any questions or comments let me know, 5:32 leave them in the comments below. 5:41 you