Tight Forearms

This can occur when there is a continued load applied to the forearm not allowing it to recover sufficiently leading to long term tightness. This load can be related to sport, repetitive manual work or DIY. It can also occur after an injury to the arm.

Long term tightness can manifest itself as reduced flexibility in the wrist e.g. reduced ability to bend the wrist forwards or backwards compared to a time before the load was applied. It can also show as fingers that are flexed more than usual and the owner may also have some elbow pain. Straight after exercise the forearm may feel “pumped” but the pumped feeling goes away quickly. Generally a massage to the forearm will reduce the tension in the short term from the arm.

Chronic tightness should be addressed as it affects muscle balance around the elbow, wrist and fingers and can contribute to injury here. I have seen some wrist symptoms improve with massage to the arm, and very interesting see how some finger pain reduces when the arm is loosened out.

What causes the forearm to tighten up? Many of the factors interlink and exist together:

1. Insufficient recovery from training sessions or an activity leading to tightness. It can take up to 72 hours to recover properly from an exercise/activity
2. Additional loading for which the arm has not yet adapted e.g. more frequent training sessions, a harder, longer or more intense training session, competitions, or a new arm heavy activity (DIY, gardening, longer hours typing at work)
3. Weakness in the musculature of the forearms – weak muscles often tighten up to try and cope with the load being applied. Additional strengthening of the wrist flexors or extensors may be required
4. Injury to the arm such as a fracture leading to weakness in the arm. See point 3
5. Incorrect biomechanics – not using the correct musculature and putting more pressure on the arm to do the activity thereby adding more load to the forearms. If you are a climber check out my post on shoulder biomechanics
6. Contribution from neural tightness (see neuromuscular forearm below)

Managing a chronically tight forearm requires dealing with any of the aggravating factors above such managing load, adequate rest, strengthening weak muscles, correcting posture and biomechanics. In the short term stretching and foam rolling the arm can help.

 

A neuromuscular forearm is a forearm that feels tight or achy and can often be described as a “pumped” like feeling that doesn’t really go away. Sometimes people can report a feeling of the arm tiring during an activity long before they expect it to. It can occur in a chronically tight forearm, but also appear in someone who hasn’t been over using the forearms.  I’ve seen it in rock climbers, desk workers and manual workers. Very commonly the person will also have neck and shoulder tightness that they are aware of.

The tightness in the forearm comes from tightness on the nerves that supply the arm. If there is pressure on the nerve along its path it can cause the muscles it supplies to tense up. This pressure can occur where it exists the spinal cord at the neck, or where travels under the collarbone and pectoral muscles (brachial plexus) and/or in the arm. The tightness in the forearm feels worse with certain neck movements which physios will test for, and often just a massage to the arm doesn’t leave it feeling much better.

Pressure on the nerves can come from wear and tear of the spine where the nerve exits the spinal cord. Poor neck posture has a significant role to play in my experience. Poor posture often leads to tightness in the neck, shoulder and pectoral muscles overlying the nerves. Often due to the muscle imbalances in the neck due to posture, the affected person no longer uses their shoulder correctly. If they are involved in an arm dominant sport, rowing, kayaking, climbing, tennis etc this can lead to further aggravation of the neck and tightness.

In most cases I see, a massage to the neck and shoulders tends to reduce the tension in the arm, before I’ve treated the arm itself. Beware of a neuromuscular forearm. Long term compression on the nerves can lead to numbness, pins and needles, loss of power, and develop into more debilitating injuries such as carpel tunnel syndrome. If in any doubt get it checked out by a health professional and follow a rehab programme to address the causative factors.

 

Chronic exertional compartment syndrome in the forearm (CECS) also has similar symptoms to neuromuscular symptoms such as forearms that quickly tighten up, but unlike the neuromuscular forearm it can feel very painful after performing gripping activities. It can lead to loss of grip strength and altered sensation in the arm. This often occurs after a specific time of doing the activity and the pain eases with rest.

 

 

It’s not very well understood, but explained simply, it is thought due to be increased pressure within the compartments of the arm leading to impaired blood flood.  It can often occur in both arms. If symptoms do not improve quickly with physio, change of technique and correction of posture to improve the flow of the blood into the arm referral will be needed to a specialist. They will carry out specific tests to diagnose this syndrome. Surgery may be required to release the tight compartment in the forearm and allow a return to sport.  In forearm CECS most surgical research presented has been on motocross riders and elite rowers but overall the incidence of CEC in the forearm seems to be rare.