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Tuesday, June 6, 2023

Tricep Dips

Brent Brookbush

Brent Brookbush

DPT, PT, MS, CPT, HMS, IMT

Tricep Dips

By Brent Brookbush MS, PES, CES, CSCS, ACSM H/FS

The tricep dip requires beyond optimal flexibility from the shoulder complex(glenohumeral and scapulothoracic joint). Optimal extension of the shoulder (gleno-humeral joint) is 20° with total shoulder complex ROM only allowing for approximately 60°. With most individuals attempting to reach 90° of shoulder complex extension, this implies that we must sacrifice the optimal length of soft tissues (hyper-mobility), or adopt a compensatory pattern at the shoulder girdle and spine.

In the case of triceps dips it is likely that the shoulder complex is both forced into hyper-mobility and adopts a compensatory movement pattern. The hyper-mobility is the result of relatively small structures having to accommodate the weight of the body. These structures include the anterior deltoid, subscapularis, long head of the biceps brachii, the shoulder capsule, and the supporting ligaments of the clavicle, scapula, and humerus. The compensatory pattern adopted will include excessive anterior tipping with the addition of elevation and upward rotation to assume a position that is not restricted by the ribs. The humerus will be forced anterior and superior in the glenoid fossa, and the cervical and thoracic spine may flex to provide additional ROM and accommodate the excessive motions of the scapula. The new position adopted by thescapula and humerus creates a potentially dangerous environment for subacromialtissues. The anterior tipping of the scapula combined with the anterior and superior glide of the humerus presses the acromion process into the humeral head. Further, the upwardly rotated position of the scapula leaves no portion of the glenoid fossa superior to the humerus decreasing joint stability and likely increasing the force transmitted superiorly into the subacromial tissues. This pattern greatly increases the risk of

developing shoulder impingement syndrome (anterior shoulder pain) as soft

tissues become damaged and inflamed from the compressive forces (specifically

the biceps tendon, supraspinatus tendon, and subacromial bursa). This position may also lead to the development of chronic syndromes as this position is synonymous with anterior subluxation of the humeral head. A position that is complicated by the excessive extension of the humerus which “wraps” the soft tissues around the superior and anterior surface of the humeral head. Although I have not heard of a dislocation occurring from this position, the mechanical force imposed on the shoulder capsule could lead to adaptive length changes that lead to long-term mechanical change and chronic instability.

The compensatory pattern noted above may reinforce common compensation patterns that could lead to adaptive shortening, and altered length/tension relationships. Specifically, the anterior tipping may lead to adaptive shortening of the pec minor, levator

scapulae, and upper trapezius, and the change in gleno-humeral position

(anterior subluxation) may lead to adaptive shortening of the supraspinatus,

subscapularis, and posterior capsule. The adaptive shortening is matched

by lengthening and weakness of the teres minor, infraspinatus, lower and middle

traps. This exercise is definitely not indicated for those with poor upper-body posture as this compensatory pattern is reinforced when loaded and repeated.

Last, why do this exercise when there are safer, more effective alternatives. Triceps dips are a combination of shoulder flexion, elbow extension, posterior tipping, and protraction of the scapula. A set of joint actions that are performed during all sagittal plane pushing motions. However, most pushing motions do not require more than the optimal ROM for any joint. For example, a sagittal plane push-up (a.k.a. a close grip push-up) uses identical

musculature through the full, ideal ROM’s allowed at the shoulder, elbow, and scapula.

© Brent Brookbush 2011

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