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Bigger arms!

Everyone wants bigger arms, but there’s no such thing as a magical workout you can do to get them.

Arms

Let´s see the most important muscles:

The Coracobrachialis is a long, slender muscle of the shoulder joint.

The contraction of the coracobrachialis leads to two movements at the shoulder joint. On one hand, it bends the arm (flexion), and on the other hand, it pulls the arm towards the trunk (adduction). To a smaller extent, it also turns the humerus inwards (inward rotation). Another important function is the stabilization of the humeral head within the shoulder joint, especially when the arm is hanging freely straight down.

 

Origin:

Coracoid process of the scapula.

Insertion:

The medial shaft of the humerus at about its middle.

The overuse of the coracobrachialis can lead to stiffening of the muscle. Common causes of injury include chest workouts or activities that require pressing the arm very tight towards the body, e.g. work on the rings in gymnastics. Symptoms of overuse or injury: pain in the arm and shoulder, radiating down to the back of the hand.

Pain and symptoms associated with the Coracobrachialis muscle
– Pain in the back of the upper arm
– Pain in the front of the upper arm around the shoulder joint
– Pain in the back of the lower arm
– Pain in the back of the hand extending down into the middle finger
– Difficulty bending the elbow
– Pain when putting arm and hand behind the head and back
– Pain when raising arm overhead
– Occasionally numbness in the upper arm that can extend into the forearm and back of the hand
Activities that cause coracobrachialis pain and symptoms
– Push ups
– Rock or rope climbing
– Throwing a ball
– Golf
– Tennis
– Lifting heavy weights with outstretched arms and palms facing up

The Biceps brachii, commonly known as the biceps, is a two-headed muscle that lies on the upper arm between the shoulder and the elbow. The Biceps muscle is actually two separate bundles of muscles (heads). The two heads of the Biceps vary in length and as a result, are called the Short and the Long Biceps heads.

 

Origin:

  1. Long head- supraglenoid tubercle and glenohumeral labrum.
  2. Short head- tip of the coracoid process of the scapula.

Insertion:

  1. Radial tuberosity.
  2. Bicipital aponeurosis.

The biceps works across three joints.

Proximal radioulnar joint (upper forearm): It functions primarily as a powerful supinator of the forearm (turns the palm upwards). This action, which is aided by the supinator muscle requires the elbow to be at least partially flexed.

Humeroulnar joint (elbow): It also functions as an important flexor of the forearm, particularly when the forearm is supinated. This action is performed when lifting an object, such as a bag of groceries. When the forearm is in pronation (the palm faces the ground), the brachialis, brachioradialis, and supinator function to flex the forearm, with minimal contribution from the biceps brachii.

Glenohumeral joint (shoulder): TIt weakly assists in forward flexion of the shoulder joint (bringing the arm forward and upwards). It also contributes to abduction (bringing the arm out to the side) when the arm is externally (or laterally) rotated. The short head also assists with horizontal adduction (bringing the arm across the body) when the arm is internally (or medially) rotated. Finally, the short head, due to its attachment to the scapula (or shoulder blade), assists with stabilization of the shoulder joint when a heavy weight is carried in the arm.

Pain and symptoms associated with the Biceps Brachii muscles
– Pain in the front of the shoulder
– Pain in the crease of the elbow
– Weakness in the arm
– Difficulty straightening arm with palm facing down
– Pain at the top of the back of the shoulder (between the neck and shoulder joint)
– Unless there is a recent injury to the biceps muscle, pain is seldom felt directly in the muscle
Activities that cause biceps brachii pain and symptoms
– Lifting heavy objects
– Chin ups, Pull ups
– Playing the violin
– Repetitive twisting of the arm with the elbow bent, ie. using a screwdriver
– The most important function of the biceps brachii is it allows us to carry objects and not pull the shoulder joint apart.
– Violinists and cellists often have problems and pain in the biceps.

The brachialis is a muscle in the upper arm that flexes the elbow joint. It lies deeper than the biceps brachii and is a synergist that assists the biceps brachii in flexing at the elbow.

 

Origin:

  1. Lower 1/2 of anterior humerus.
  2. Both intermuscular septa.

Insertion:

  1. Ulnar tuberosity.
  2. Coronoid process of ulna slightly.

Its primary action is to flex the forearm muscles at the elbow. Due to its high contractile strength, the branchialis makes many arm and elbow movements possible. Such movements are important for the activities of daily life. Because movements involving the arms and elbows are almost always continuous, injuries to the brachialis muscle are quite common.

Pain and symptoms associated with the Brachialis muscle
– Pain at the front and /or back of the base of the thumb
– Constant aching and/or tightness in the outside of the upper arm near the elbow
– Numbness or tingling in the forearm and thumb
– Difficulty bending the elbow
Activities that cause brachialis pain and symptoms
– Lifting heavy objects with a bent elbow
– Picking up children
– Holding up heavy tools
– Working at the computer
– Chin ups
– Playing the oboe, clarinet, and saxophone

The Triceps Brachii muscles are located on the back of the humerus and more commonly referred to as the triceps. The triceps muscles have three muscle heads: Lateral, Medial and Long head.

 

Origin:

  1. Long head: infraglenoid tubercle of the scapula.
  2. Lateral head: upper half of the posterior surface of the shaft of the humerus, and the upper part of the lateral intermuscular septum.
  3. Medial head: posterior shaft of humerus, distal to radial groove and both the medial and lateral intermuscular septum (deep to the long & lateral heads).

Insertion:

  1. Posterior surface of the olecranon process of the ulna.
  2. Deep fascia of the antebrachium.

Primarily responsible for the extension of the elbow joint (straightening of the arm). It can also fixate the elbow joint when the forearm and hand are used for fine movements, e.g., when writing. The lateral head is used for movements requiring occasional high-intensity force, while the medial fascicle enables more precise, low-force movements.

With its origin on the scapula, the long head also acts on the shoulder joint and is also involved in retroversion and adduction of the arm.

Pain and symptoms associated with the Triceps Brachii muscle
– Pain in the back of the shoulder
– Pain at the base of the neck
– Pain on the outside of the elbow
– Pain throughout the back of the elbow
– Feeling of weakness in the elbow
– Pain in the back of the upper arm
– Can make elbow hypersensitive
– Occasionally pain and/or burning down into the fourth and fifth fingers
– Difficulty straightening and bending the elbow
– Pain is usually dull and aching, rarely is the pain sharp or stabbing
Activities that cause triceps brachii muscle pain and symptoms
– Tennis
– Golfing
– Swinging a baseball bat
– Repetitive pushing downward action
– Forcefully holding something down.

The anconeus muscle (or anconaeus/anconæus) is a small muscle on the posterior aspect of the elbow joint.

Anconeus

Origin:

Posterior surface of the lateral epicondyle of the humerus.

Insertion:

Lateral aspect of olecranon extending to the lateral part of ulnar body.

It assists in extension of the elbow, where the triceps brachii is the principal agonist, and supports the elbow in full extension. It also prevents the elbow joint capsule being pinched in the olecranon fossa during extension of the elbow. Anconeus also abducts the ulna and stabilizes the elbow joint. Anconeus serves to make minute movements with the radius on the ulna. In making slight abduction of the ulna, it allows any finger to be used as a axis of rotation of the forearm.

Activities That Cause Pain and Symptoms of the Anconeus

– Forced and repetitive gripping of a large and/or wide object
– Extreme sudden hard extension (straightening) of the elbow
– Pushing a door closed
– Rotating arm to shake hands
– Golfing (non-dominate arm)
– Tennis (dominant arm)
– Rowing motions

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Shoulder

When we talk about the shoulder we usually mean the deltoid. There are more important muscles around your shoulder joint than deltoid, like the rotator cuff muscles, and you should take care of them to avoid injuries.

The Deltoid muscle is the muscle forming the rounded contour of the shoulder. It is divided into three portions, anterior, lateral and posterior, with the fibers having different roles due to their orientation.

Deltoid

  1. The anterior fibers are involved in shoulder abduction when the shoulder is externally rotated. It also works with the subscapularis, pecs and lats to internally (medially) rotate the humerus.
  2. The posterior fibers are strongly involved in transverse extension particularly as the latissimus dorsi is very weak in strict transverse extension. The infraspinatus and teres minor, also work with the posterior deltoid as external rotators, antagonists to strong internal rotators like the pecs and lats. The posterior deltoid is also the primary shoulder hyperextensor, more so than the long head of the triceps which also assists in this function.
  3. The lateral fibers perform the shoulder abduction when it is internally rotated, and perform shoulder transverse abduction when the shoulder is externally rotated.

Origin:

  1. Lateral, anterior 1/3 of the distal clavicle.
  2. Lateral boarder of the acromion.
  3. Scapular spine.

Insertion:

Deltoid tuberosity of the humerus.

Pain and symptoms associated with the Deltoid muscle

– Pain over the tip of the shoulder going down the upper arm
– Shoulder weakness
– Pain in the shoulder area when lifting
– Pain in the shoulder area when holding objects up and in front of the body
– Pain decreases when arm and shoulder are at rest

Pain around the shoulder area caused by the deltoids muscles will subside when resting. If the pain in the deltoid area is continuous even at rest, chances are the source of the pain is being caused by other muscles in the neck, shoulder, upper back, and/or chest.

Activities that cause deltoid pain and symptoms

– Swimming
– Skiing
– Weight-lifting
– Throwing a ball; baseball, softball, football
– Holding heavy tools up
– Picking up and carrying children
– Typing when the keyboard is set up too high

The Teres major is a medial rotator and adductor of the humerus and assists the latissimus dorsi in drawing the previously raised humerus downward and backward (extension, but not hyperextension). It also helps stabilize the humeral head in the glenoid cavity. It is only functional when the Rhomboids fix the scapula. This muscle mainly helps latissimus dorsi.

Origin:

Inferior, lateral margin of the scapula.

Insertion:

Crest of lesser tubercle (just medial to the insertion of latissimus dorsi)

Pain and symptoms associated with the Teres Major muscle

– Pain in the back of the upper arm when reaching forward and up
– Sharp pain in the back of the shoulder with aching sensation in the upper arm when resting elbows on a table.
– Pain in the back of the arm that skips the elbow and continues down to the back of the forearm.

Activities that cause teres major muscle pain and symptoms

– Rowing
– Throwing or pitching a ball
– Swimming
– Chopping wood
– Driving
– Exercise that requires pulling up (chin-up) or pushing down (push-ups) with the arms, or reaching forward or overhead repetitiously

The Supraspinatus muscle is one of the four muscles which make up the rotator cuff. Its main function is to stabilize the upper arm by holding the head of the humerus in position. It is important in throwing motions to control any forward motion of the head of the humerus. Contraction of the supraspinatus muscle leads to the abduction of the arm at the shoulder joint. It is the main agonist muscle for this movement during the first 10-15 degrees of its arc. Beyond 30 degrees, the deltoid muscle becomes increasingly more effective at abducting the arm and becomes the main propagator of this action.

Origin:

  1. Supraspinous fossa.
  2. Muscle fascia.

Insertion:

Uppermost of three facets of the greater tubercle of the humerus.

Pain and symptoms associated with the Supraspinatus muscle

– Deep ache over the outside of the shoulder area which continues during rest
– Pain down the outside of the arm, occasionally extending down into the wrist
– Can cause clicking or popping in the shoulder joint
– Concentrated pain toward the outside of the elbow
– Pain when lifting the arm overhead
– Difficulty and shoulder pain while shaving the face or combing hair

Activities that cause supraspinatus muscle pain and symptoms

– Carrying heavy objects with the arm hanging down ie. suitcase, a bucket of paint, etc.
– Working with arms outstretched in front of the body and /or overhead (painting, working at the computer, driving for long periods)
– Tennis
– Golf

The Infraspinatus muscle is another of the four rotator cuff muscles crossing the shoulder joint and is commonly injured. It is the main external rotator of the shoulder joint. When the arm is fixed, it abducts the inferior angle of the scapula. Its synergists are teres minor and the deltoid. The infraspinatus and teres minor rotate the head of the humerus outward (external, or lateral, rotation); they also assist in carrying the arm backward. Also, reinforces the capsule of the shoulder joint.

Origin:

  1. Infraspinous fossa.
  2. Muscle fascia.

Insertion:

The middle facet of greater tubercle of the humerus.

Pain and symptoms associated with the Infraspinatus muscle

– Pain deep in the front of the shoulder
– Pain going down the front and outside of the arm, sometimes going down into the hand
– Pain going up the back of the neck to the base of the skull
– Pain in the upper back at the inside edge of the shoulder blade
– Weakness and stiffness in the shoulder and arm
– Difficulty reaching the arm behind the body and reaching into a back hip pocket

Activities that cause infraspinatus pain and symptoms

– Keeping the arms overhead for extended periods of time
– Painting overhead
– Keeping the arms extended in front of the body for extended periods of time
– Driving with hands on top of the steering wheel
– Keyboarding and using the mouse on the computer
– Swimmers
– Sports throwing a ball or swinging at a ball
– Tennis
– Baseball
– Football

The subscapularis rotates the head of the humerus medially (internal rotation); when the arm is raised, it draws the humerus forward and downward. It is a powerful defense to the front of the shoulder-joint, preventing displacement of the head of the humerus.

Origin:

Subscapular fossa.

Insertion:

Lesser tubercle of the humerus.

Pain and symptoms associated with the Subscapularis muscle

– Severe pain deep in the back of the shoulder
– Pain in the back of the upper arm
– Pain over the shoulder blade area
– Pain can extend down the back of the arm
– Persistent aching in the wrist with extreme tenderness in the back of the wrist
– Occasionally an extremely tender spot on the front of the shoulder

Activities that cause subscapularis pain and symptoms

– Pitching a baseball
– Tennis
– Swimming
– Tossing heavy objects
– Playing the violin, guitar, banjo
– Falling and landing on your side
– Sleeping on one side
– Immobilization of the arm for long periods (casted arm)

The Teres minor is a narrow, elongated muscle of the rotator cuff.

The Teres minor and the infraspinatus attach to the head of the humerus; they help hold the humeral head in the glenoid cavity of the scapula. They work in tandem with the posterior deltoid to externally (laterally) rotate the humerus, as well as perform transverse abduction, extension, and transverse extension.

Origin:

The middle half of the scapula’s lateral margin.

Insertion:

Lowest of three facets of the greater tubercle of the humerus.

Pain and symptoms associated with the Teres Minor muscle

– Pain toward the back of the upper arm
– Numbness or tingling without pain or aches in the fourth and fifth fingers

Activities that cause teres minor pain and symptoms

– Bringing the arm back with force
– Pitching a baseball
– Rowing, Kayaking
– Holding arms above head for extended periods
– Holding arms out in front of the body for extended periods of time
– Bracing your arms either in front of the body to avoid a fall or overhead impact (something falling from above)

There are two types of rotator cuff injuries:

  1. Acute tears occur as a result of a sudden movement. This might include throwing a powerful pitch, holding a fast moving rope during water sports, falling over onto an outstretched hand at speed, or making a sudden thrust with the paddle in kayaking.
  2. A chronic tear develops over a period of time. They usually occur at or near the tendon, as a result of the tendon rubbing against the underlying bone.

Rotator cuff tear

Please, be careful :)

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«Lats» & friends

We usually forget that lats belong to another muscle group, the superficial back muscles. They originate from the vertebral column and attach to the bones of the shoulder – the clavicle, scapula, and humerus. All these muscles are therefore associated with movements of the upper limb.

The muscles in this group are the latissimus dorsi, trapezius, levator scapulae and the rhomboids.

The latissimus dorsi is the larger, flat, dorsolateral muscle on the trunk, posterior to the arm, and partly covered by the trapezius on its median dorsal region.

Origin:

  1. Spinous process of T7-L5.
  2. Upper 2-3 sacral segments.
  3. Iliac crest.
  4. Lower 3 or 4 ribs.

Insertion:

Lateral lip of the intertubercular groove.

It is responsible for extension, adduction, horizontal abduction, flexion from an extended position, and (medial) internal rotation of the shoulder joint. It also has a synergistic role in extension and lateral flexion of the lumbar spine.

Pain and symptoms associated with the Latissimus Dorsi muscle
– Pain is felt in the mid-back especially below the bottom of the shoulder blade.
– Pain is felt in the front of the shoulder.
– Pain in the side and or mid-back similar to a side stitch.
– Numbness, tingling and/or aching that extends down the arm to the little finger and often the ring finger.
– Pain while reaching forward with the arms
– Pain when lifting arms overhead
– Can contribute to breathing difficulty.
– Pain does not worsen with activity nor does it ease at rest, it is steady and constant.
Activities that can cause latissimus dorsi pain
– Activities that require continuously or repeatedly raising the shoulders
– Gymnastics
– Rowing
– Throwing or pitching a ball
– Swimming
– Swinging a baseball bat
– Swinging a tennis racket
– Shoveling dirt or snow
– Chopping wood
– Exercise that requires pulling up (chin up) or pushing down (push-ups) with the arms
– Reaching forward or overhead repetitiously

The trapezius is a broad, flat and triangular muscle. The muscles on each side form a trapezoid shape. It is the most superficial of all the back muscles.

 

Origin:

  1. External occipital protuberance.
  2. Along the medial sides of the superior nuchal line.
  3. Ligamentum nuchae (surrounding the cervical spinous processes).
  4. Spinous processes of C1-T12.

Insertion:

  1. Posterior, lateral 1/3 of clavicle.
  2. Acromion.
  3. The superior spine of the scapula.

It has three functional regions:

  1. Superior (descending part), which supports the weight of the arm.
  2. Intermediate (transverse part), which retracts the scapulae.
  3. Inferior (ascending part), which medially rotates and depresses the scapulae.

Contraction of the trapezius muscle can have two effects:

  1. Movement of the scapulae when the spinal origins are stable.
  2. Movement of the spine when the scapulae are stable. Its main function is to stabilize and move the scapula.
Pain and symptoms associated with the Trapezius muscle
– Headache in the temple area
– Pain in the jaw that travels down into the neck and over behind the ear
– Pain behind one eye
– Tension headache
– Contributes to dizziness
– Pain at the base of the skull
– Stiff neck
– Ache or burning sensation in the middle of the back
– Pain or tingling during raising or lowering the arms
Activities that cause pain and symptoms in the trapezius
– Whiplash
– Lifting heavy objects
– Working with your arms out in front of you (computer, playing the piano, driving)
– Keeping your shoulders rolled forward or pulled up
– Carrying a heavy purse or backpack on one shoulder
– Large breasts

The levator scapulae is a small strap-like muscle. It elevates the scapula.

Origin:

Transverse processes of C1-C3 or C4.

Insertion:

The superior angle of scapula toward the scapular spine.

Pain and symptoms associated with the Levator Scapulae muscle
– Pain at the slope of the neck and shoulder
– Stiff neck, difficulty turning head to look over the shoulder
– Headaches at the base of the skull
– Occasionally pain from the top of the shoulder blade extending to the middle of the shoulder blade
Activities that cause pain or symptoms of the levator scapulae muscle
– Keeping head turned to one side ie. Sleeping on stomach, holding phone to ear with shoulder
– Sleeping without proper head support
– Acute upper respiratory infection will cause the levator scapulae to shorten and become stiff and painful
– Painting overhead for extended periods
– Carrying heavy backpacks or purses
– Whiplash
– Forward head posture

There are two rhomboid muscles, major and minor. The rhomboid major helps to hold the scapula (and thus the upper limb) onto the ribcage. Together with the rhomboid major, the rhomboid minor retracts the scapula when trapezius is contracted. Acting as an antagonist to the trapezius, the rhomboid major and minor elevate the scapula medially and upward, working in tandem with the levator scapulae muscle to rotate the scapulae downward. While other shoulder muscles are active, the rhomboid major and minor stabilize the scapula.

Rhomboid major:

Origin:

  1. Spinous processes of T2-T5.
  2. Supraspinous ligament.

Insertion:

Medial scapula from the scapular spine to the inferior angle

Rhomboid minor:

Origin:

  1. Spinous process of C7 & T1.
  2. Ligamentum nuchae.
  3. Supraspinous ligament.

Insertion:

Medial margin of the scapula at the medial angle

Pain and symptoms associated with the Rhomboid Major and Minor muscles
– Pain along the inside of the shoulder blade especially noticeable at rest.
– Popping and/or grinding noise when moving the shoulder blade
– Inability to straighten the upper body out of a slumped position
Activities that can cause rhomboid muscle pain
– Activities that require continuously or repeatedly raising the shoulders
– Hanging wallpaper
– Rowing
– Throwing a ball
– Pull Ups
– Extended work at the computer
– Military posture: standing with extremely straight posture with shoulders pulled back, chest thrust forward.
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Pecs

We usually call our pectoral muscles «pecs».  The first thing we need to know is that pectoral muscles are a group of muscles.

The pectoralis major makes up the bulk of the chest muscles in the male and lies under the breast in the female.

 

Origin:

  1. Medial 1/3 of the clavicle.
  2. Anterior aspect of manubrium & length of the body of the sternum.
  3. Cartilaginous attachments of upper 6 ribs.
  4. External oblique’s aponeurosis.

Insertion:

  1. Lateral lip of bicipital groove to the crest of the greater tubercle.
  2. Clavicular fibers insert more distally; sternal fibers more proximally.

It performs four actions:

  1. Flexion of the humerus, as in throwing a ball side-arm, and in lifting a child.
  2. Adducts the humerus, as when flapping the arms.
  3. Rotates the humerus medially, as occurs when arm-wrestling.
  4. Keeps the arm attached to the trunk of the body.
Pain and symptoms associated with the Pectoralis Major muscle
– Chest pain
– Pain in the front of the shoulder
– Pain in the inner arm, inner elbow traveling down to the into the middle and ring fingers
– Breast pain
– Upper back pain between and around the shoulder blades
– Pain when trying to reach behind the body
– Rounded shoulder posture
– Contributor to forward head posture
Activities that cause pain and symptoms of the pectoralis major muscle
– Lifting heavy objects
– Working with your arms out in front of you (computer)
– Driving and horseback riding: both require you to hold your arms up and in front of your body
– Keeping your shoulders rolled forward or pulled up
– Slouching
– Carrying a heavy purse or backpack on one shoulder
– Large breasts

The pectoralis minor is a thin, triangular muscle, situated at the upper part of the chest, beneath the pectoralis major. The pectoralis minor depresses the point of the shoulder, drawing the scapula inferior, towards the thorax, and throwing its inferior angle posteriorly.

 

Origin:

The outer surface of ribs 2-5 or 3-5 or 6.

Insertion:

Medial aspect of the coracoid process of the scapula.

Pain and symptoms associated with the Pectoralis Minor muscle
– Chest pain
– Burning and stabbing like pain in the pectoral (chest) area
– Pain in the front of the shoulder
– Pain in the inner arm, inner elbow traveling down to the into the fourth and fifth fingers
– Numbness in the inside of the forearm, wrist, hand and fingers
– Difficulty reaching forward and up
– Pain in the upper back between the shoulder blades
– Pain when reaching behind the body
– Rounded shoulder posture
Activities that cause pectoralis minor pain and symptoms
– Lifting heavy objects
– Pushing things away from the body
– Push ups
– Lifting objects with arms straight in front of the body
– Working with your arms out in front of you (computer)
– Keeping your shoulders rolled forward or pulled up
– Carrying a heavy purse or backpack on one shoulder
– Hyperventilation, difficulty breathing
– Chronic cough
– Under-wire bras
– Large breasts
– Whiplash

The subclavius is a small triangular muscle, placed between the clavicle and the first rib. Along with the pectoralis major and pectoralis minor muscles, the subclavius muscle makes up the anterior wall of the axilla.

Subclavius

Origin:

First rib about the junction of bone and cartilage.

Insertion:

The lower surface of the clavicle.

The subclavius depresses the shoulder, carrying it downward and forward. It draws the clavicle inferiorly as well as anteriorly. Also, protects the underlying brachial plexus and subclavian vessels from a broken clavicle (the most frequently broken long bone).

Pain and symptoms associated with the subclavius muscle

– Pain below the collarbone
– Pain in the upper arm
– Sends pain down the forearm into the thumb, forefinger, and middle finger
– A reliable indicator of subclavius muscle dysfunction is a pain on the outside of the upper arm that skips over the elbow then extends into the forearm. Pain can also extend to the thumb, index, and middle finger while skipping over the wrist.
– The muscle can tighten restricting circulation to the arm and hand causing tingling and numbness

Activities that cause subclavius pain and symptoms

– Lifting heavy objects
– Working with your arms out in front of you (computer, driving)
– Keeping your shoulders rolled forward
– Sleeping on your side with your arm above your head
– Broken clavicle

 

The serratus anterior is found more laterally in the chest and, forms the medial wall of the axilla.

Serratus anterior

Origin:

Fleshy slips from the outer surface of upper 8 or 9 ribs.

Insertion:

The costal aspect of medial margin of the scapula.

The main action of the serratus anterior is to rotate the scapula, allowing the arm to be raised over 90 degrees. It also holds the scapula against the rib cage – this is particularly useful when upper limb reaches anteriorly (e.g punching).

Pain and symptoms associated with the Serratus anterior

– Pain on the side of the chest toward the middle of the ribcage
– Pain down the arm to the fourth and fifth fingers
– Pain below the shoulder blade
– Difficulty breathing
– Inability to take a deep breath
– Sharp pain in the side (side stitch)
– Pain and difficulty reaching behind the body
– Pain and difficulty when pulling shoulders back
– Sensitivity in and around the area of the breast

Activities that cause serratus anterior pain and symptoms

– Swimming
– Tennis
– Chin ups, Push ups
– Weightlifting
– Gymnastics
– Hyperventilation
– Severe coughing

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Little Mikes

I had some free time this morning. I decided to cook. The most difficult thing is to translate. Probably most of you know them with another name. Here we call them «miguelitos», something like «little Mikes». Summarizing: puff pastry with cream :)

We´ll need:

  1. Puff pastry. Can you believe it?
  2. One egg.

Miguelito1

Extend the puff pastry and well, you know what to do with the egg :)

With a paintbrush, paint your puff pastry with the egg. Then, cut the pastry as you like!

Preheat the oven to 180ºC.

Miguelito2

Bake at 180ºC, 10-15 minutes.

Miguelito3

For the cream:

  1. 36 grs of cornflour.
  2. 90 grs of white sugar.
  3. 500 ml of milk.
  4. 4 yolks
  5. Lemon peel

Miguelito4

  1. Mix sugar and cornflour.
  2. Add the yolks
  3. Stir well.

Meanwhile:

MiguelitoHorno1

  1. Add milk to the mix and stir again.
  2. Add the lemon peel.
  3. Cooking at low temperature, keep stirring until you get a thick texture.

Miguelito5

  1. Put the cream on a plate.
  2. Remove the lemon peel.
  3. Cover the cream with transparent paper.
  4. Wait until it gets the ambient temperature.

Miguelito8

Keep an eye on:

MiguelitoHorno2

  1. Remove when is golden.
  2. Wait and cut them.

Miguelito6

  1. Fill the puff pastry with the cream.
  2. Cover with sugar glass.

Miguelito7

ENJOY :D