Therapeutic exercise
Supine Skull Crusher (HSR)
Heavy slow loading for the triceps brachii in an HSR (Heavy Slow Resistance) pattern, following Kongsgaard's protocol. The final phase of triceps tendinopathy rehabilitation, when the patient already tolerates controlled eccentric loading and needs greater cumulative load.
How to perform
- Starting position. Lie on a flat bench with a moderate dumbbell (4–8 kg) in each hand and the arms extended toward the ceiling.
- Step 2. Keeping the elbows still and pointing upward (perpendicular to the floor), flex only the elbows, lowering the dumbbells toward the forehead, over 3–4 seconds.
- Step 3. Stop the dumbbells 5 cm from the forehead and hold for 1 second.
- Step 4. Extend the elbows over 2 seconds, returning to the starting position without locking out completely (maintains continuous tension on the triceps).
- Return. Keep the movement slow and controlled — never use momentum or acceleration.
When not to perform
- Partial or complete triceps tendon rupture
- Tendinopathy in an acute reactive phase
- Olecranon bursitis
- Recent elbow surgery
- Acute rotator-cuff injury (positioning with arms over the body)
- Decompensated cardiovascular disease (progressive load with cardiovascular demand)
Medical disclaimer. These exercises are presented for informational purposes only. Always consult your physician before starting any exercise program, especially in case of acute pain, recent injury, or underlying clinical condition.
Related Exercises
Overhead Triceps Stretch
Classic stretch of the triceps brachii in its proximal portion (long head). Fundamental in the treatment of triceps tendinopathy — maintains tendinous flexibility while eccentric loading remodels the tendon.
Triceps Isometric Wall Hold
Isometric contraction of the triceps brachii in elbow extension against a wall. The first stage of triceps tendinopathy treatment at the olecranon insertion — produces immediate analgesia without overloading the reactive tendon.
Triceps Pulley with Eccentric Emphasis
Resisted elbow extension with emphasis on the eccentric phase (controlled descent). In triceps tendinopathy, slow and heavy loading during descent is the main stimulus for tendon remodeling — following the same principle as the Alfredson protocol adapted to the triceps.