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Grip Strength:
Unleash the secret to primal
strength,
injury prevention,
and overall health
By: Dr. Arianne Missimer, PT, DPT, RD, SFG2, CICS, CSCS, T.P.I. MP 3, K‐Vest 3, FMT 1 & 2, NKT 2, FMS/SFMA, MI EBFA
Clinic Director Kinetic Physical Therapy Founder of the Movement Paradigm
Grip strength is the force applied by the hand to pull or
suspend from objects and is a specific part of hand
strength
• Grip strength is correlated with the strength of the upper extremity, general strength of the body and some anthropometric measurements (Balogun et al., 1991)
• Grip power is the result of forceful flexion of all finger joints with maximum voluntary force that the subject is able to exert under normal biokinetic conditions (Koley et al., 2009). Objectives
1. Recognize importance of grip strength for injury prevention, rehabilitation, and performance 2. Understand co‐activation pattern, myofascial lines, and hyperirradiation
3. Identify reliable measures for testing grip strength
4. Recognize appropriate treatment interventions and proper progressions for your athletes , patients, and clients
There is more than 17,000
mechanoreceptors in the
hand!
Neuroscience. 2nd edition.
Purves D, Augustine GJ, Fitzpatrick D,
et al., editors. Sunderland (MA): Sinauer Associates; 2001.
Neuroscience. 2nd edition.
Purves D, Augustine GJ, Fitzpatrick D, et al., editors.
Sunderland (MA): Sinauer Associates; 2001.
How does grip improve stability, strength, and force
production?
1. Co-activation patterns
2.Myofascial lines
via fascial
tensioning
3. Hyperirradiation
Neurological connection of grip and RTC
Roberts LV, Stinear CM, Lewis GN, and Byblow
WD. “Task‐Dependent Modulation of Propriospinal Inputs to Human Shoulder.” Journal of Neurophysiology 100.4 (2008): 2109‐
114. Rehabilitation • Improved joint centration • “….Anterior and middle deltoid activity decreased by 2% MVE, while posterior deltoid, infraspinatus and trapezius activity increased by 2% MVE and biceps brachii activity increased by 6% MVE.”
Antony NT, Keir PJ. Effects of Posture, Movement and Hand Load on Shoulder Muscle Activity. Journal of Electromyography and Kinesiology 20.2: 191‐98. 2010. Hyperirradiation “a spreading and increased spread of a response”
Hyperirradiation • The Law of Irradiation was discovered by Sir Charles Scott Sherrington • "A muscle working hard recruits the neighboring muscles, and if they are already part of the action, it amplifies their strength. The neural impulses emitted by the contracting muscle reach other muscles and 'turn them on' as an electric current starts a motor".
• Increases neural drive Adler S, Beckers D, and Buck M. PNF in Practice: An Illustrated Guide. Berlin: Springer, • Increased strength in UQ 2000. Radiant Tension Myofascial Arm Lines
Deep front line
Superficial front line
Deep back line
Superficial back line Myers TW. Anatomy Trains. Myofascial Meridians Manual for Movement Therapists. Second Edition. Edinburgh, CA: Elsevier; 2009.
Myofascial Arm Lines
Deep Front Line Pec Minor
Biceps Brachii
Thenar muscles Superficial Front Line
Pec Major and Lats
Flexor group
Carpal Tunnel Deep Back Line
Rhomboids and Levator
Triceps brachii
Hypothenar muscles
Superficial Back Line Trapezius
Deltoid
Extensor group Functional
Lines
Myers TW. Anatomy Trains. Myofascial Meridians Manual for Movement Therapists. Second Edition. Edinburgh, CA: Elsevier; 2009.
“Grip strength is a predictor of mortality, disability, complications, and increased length of hospital stay.”
Rantanen T, Guralnik JM, Foley D et al. Midlife hand grip strength as a predictor of old age disability. JAMA 1999; 281: 558–60.
Assessments
• Men 50# DB in each hand x 30 sec
• Women and kids #35 DB in each hand x 30 sec
– Loaded posture, breathing, compensations
• Dynamometer
Dynamometer • Quantified by measuring the amount of static force that the hand can squeeze around a dynamometer. • The Jamar dynamometer has been found to give the most accurate and acceptable measures of grip strength
Standardized testing protocol
• Seated with the shoulder adducted and neutrally rotated, the elbow flexed at 90 and forearm in neutral and the wrist between 0 and 30 degrees extension and between 0 degrees and 15 degrees ulnar deviation (Fess & Moran, 1981). • Small changes in body position can result in altered grip strengths.
Grip Types
• Crushing Grip
• Pinch Grip
• Open Hand Grip
How do you effectively train grip ?
Hanging!!
Treatment
• Kettlebell holds, screwdrivers, arm bars, TGU
• Block weights • Hook Grip Kettlebell Swinging
• Thick bar dumbbells (2.5” diameter)
• Pinch plates
• Sledgehammers
Summary
• Grip strength is widely accepted indicator of nutritional status, bone mineral content, muscular strength and functional integrity of upper extremity .
• The assessment of grip strength plays a vital role in determining the efficacy of different treatment strategies of hand, elbow, shoulder, and core. • Unleash this secret of primal strength, injury prevention, and longevity. References
Au AK, Keir PJ. Interfering effects of multitasking on muscle activity in the upper extremity. J Electromyogr Kinesiol
2007;17:578–86.
Adler S, Beckers D, and Buck M. PNF in Practice: An Illustrated Guide. Berlin: Springer, 2000.
Antony NT, Keir PJ. Effects of Posture, Movement and Hand Load on Shoulder Muscle Activity. Journal of Electromyography and
Kinesiology 20.2: 191-98. 2010.
Bohannon RW. Muscle strength: clinical and prognostic value of hand-grip dynamometry. BMC Musculoskelet Disord. 2015; 16:
139.
Hogrel JY. Grip strength measured by high precision dynamometry in healthy subjects from 5 to 80 years. J Nutr Health Aging.
2012;16(9):769-74.
Jedd Johnson- Diesel Crew. [email protected]
Myers TW. Anatomy Trains. Myofascial Meridians Manual for Movement Therapists. Second Edition. Edinburgh, CA: Elsevier;
2009.
Norman K, Stobaus N, Gonzalez MC, Schulzke JD, Pirlich M. Hand grip strength: outcome predictor and marker of nutritional
status. Clin Nutr. 2011 Apr;30(2):135-42.
Neuroscience. 2nd edition. Purves D, Augustine GJ, Fitzpatrick D, et al., editors. Sunderland (MA): Sinauer Associates;
2001.
References
PNF course. Institute of Physical Art. April 2013
Rantanen T, Guralnik JM, Foley D et al. Midlife hand grip strength as a predictor of old age disability. JAMA 1999; 281: 558–60.
Roberts LV, Stinear CM, Lewis GN, and Byblow WD. “Task-Dependent Modulation of Propriospinal Inputs to Human Shoulder.”
Journal of Neurophysiology 100.4 (2008): 2109-114. - See more at:
Sporrong H, Palmerud G, Herberts P. Influences of handgrip on shoulder muscle activity. Eur J Appl Physiol Occupat Physiol 71:
485–492, 1995.
Sporrong H, Palmerud G, Herberts P. Hand grip increases shoulder muscle activity: an EMG analysis with static hand contractions
in 9 subjects. Acta Orthop Scand 67: 485–490, 1996.
Sporrong H, Styf J. Effects of isokinetic muscle activity on pressure in the supraspinatus muscle and shoulder torque. J Orthop Res
17: 546 –553, 1999.
Stevens PJ, Syddall HE, Patel HP, Martin HJ, Cooper C, Aihie SA. Is grip strength a good marker of physical performance among
community-dwelling older people? Curr Opin Clin Nutr Metab Care. 2015 Sep;18(5):465-70.