Help learning anatomy? Try less flashcards

Posted on July 8, 2020

(Last Updated On: July 8, 2020)

One of the most common remarks I’ve gotten is something related to difficulty learning and understanding anatomy.

Learning is obviously quite individual. So, this post is clearly biased from my experience, but maybe it’ll still be helpful.

Flash cards might help, but that’s an arduous, incomplete, approach

Based on what I’ve witnessed college classmates and other health professionals do, and me guessing, I assume this is the most common approach.

Write down a muscle’s name, then try to memorize:

  • Origin
  • Insertion
  • Action

Wikipedia tells us there are 320 muscles in the body (with 320 contralateral counterparts).

Typically in an exercise science context you’re not having to memorize the foot, hand, eye, mouth, face muscles (though you might want to learn some of these). Those are dense areas (lots of muscles). Let’s say you have at least 250 to memorize.

That’s 250 muscle names, 250 origins, 250 insertions, 250 actions, a lot of ’em and you’ll want to know the nerve innervation…

I don’t care if you’re winning memory contests, it’s a lot.

To some degree, there is no avoiding you’re going to have to sit down and make your eyes bleed, but there are adjuncts you can use to help, and hopefully make it more interesting and enjoyable.

Examine muscle fibers, not just a random list of facts

My favorite strategy was to look at the muscle in detail first, try to envision what it does, then read its attributes.

-> I’ve primarily done this by looking at pictures of muscles, but another helpful approach can be to draw the muscles yourself. There can be a nice relationship between hand movement and memorization, much like how taking notes helps people vs only listening to a lecture.

Let’s do a common one, biceps brachii.

bicep pain

In a full contraction, muscle fibers will pull towards their center.

So, without having to get too granular, you can see the biceps brachii connects above and below the humerus (upper arm).

Thus, you can quickly deduce the biceps brachii is going to bring what’s above and below the humerus towards one another.

For instance, it will pull the bottom of the arm towards the top of the arm => elbow flexion.

I’m not sure who originally made this.

BUT, lesser appreciated is it has a role to play when the scapula moves towards the humerus too => scapular anterior tilt.

Lateral view of the scapula. Red is anterior tilt; green is posterior tilt.

In a formal setting, like a college class, unless you have a sadistic professor, in something like a multiple choice test, usually you’ll be able to quickly eliminate options from this. For instance, you get the question “What is the insertion of the biceps brachii?”

You have four multiple choice options. You can quickly go through the process:

Biceps brachii => inserts at the top and front of the forearm => only 1 or 2 of these choices connects there => boom, you’ve eliminated a lot of the other choices

From a practical perspective, in the context of exercise science, you won’t usually need to know the exact insertion points anyways. (If you’re a surgeon, that’s a different matter.)

Furthermore, at least in my experience, in formal environments all anybody ever really talks about in terms of action is what happens when the insertion (what’s most distal) moves towards the origin (what’s most proximal). But what this interpretation is really saying is “when the origin is fixed (not moving), the muscle will move the insertion towards the origin.”

While many times this is what’s most relevant, it’s an incomplete understanding as muscles don’t contract in one direction. They pull from both sides.

For instance, if you’re, for sake of argument, concerned with generating scapular anterior tilt, then you’re probably going to think about pec minor.

Pulls the front of the scapula down toward the ribs. We don’t really worry about it’s ability to pull the ribs up to the scapula, because the path of least resistance is way more in favor of the scapula than the ribs.

Said another way, if you want to grow your biceps, doing scapular anterior tilt exercises aren’t really a great targeting strategy.

But if you’re -the much more likely scenario- dealing with someone who has chronic scapular anterior tilt problems e.g. rounded shoulders, and you’re trying to avoid anterior tilting, then you might want to also be concerned with how much bicep work the person has been doing, and their technique while doing so.

Or if you’re interested in stretching the biceps, but you’re not paying attention to the position of the scapula, you can be misguided. If the person extends (straightens) their elbow in attempt to stretch their bicep, but the scapula is anteriorly tilted, you’re not getting as good of a stretch as you could.

When we stretch muscles, we’re most effective when we focus on both ends:

We can even get a decent stretch if we keep one side fixed while pulling the other:

But if we stretch one end while letting the other slacken too much:

Lengthen one side, followed by shortening the other = no net stretch.

We might not be stretching the muscle much, if at all.

Or if you’re just interested in maximally hitting your biceps, you should be aware of whether you’re anteriorly tilting your scapula.

Getting deeper

What often happens to someone attempting heavy curls, besides the swinging of their torso (which becomes a lower back exercise), is they’ll tilt their scapulae as they try curling their elbows.

This helps shorten their biceps but without load, as there is no resistance against the scapula anteriorly tilting (the resistance is against the elbows flexing).

Notice how the person leans forward first, then has some tilt of their scapula as they try to curl.

Made from this video, where the tilting may be more obvious:

Good scapula view:

Remember just think of scapular anterior tilt as the shoulders rounding forward

Or notice this guy. If you watch his shoulders, you can see him rotating into anterior tilt as he lowers the bar:

He should be doing an eccentric contraction -using the biceps as they lengthen- but he’s actually not lengthening them as effectively as he could be. As he attempts to straighten his elbows on the way down, he concurrently tightens the bicep some by having the scapulae anteriorly tilt.

They’re doing a version of this (notice how much their necks are jutting out forward (extending)):

Notice how much this guy’s head tilts back / chin tilts up / neck extends as he tries to curl:

If you have someone with forward head posture who wants to change it, you might also be concerned with how they do bicep curls!

Or another thing people do is pull their elbows back (humeral extension) before they curl. Notice how this guy’s elbows also moved backward before really curling the bar upwards. On the picture on the left, you can see his lower back. As the pictures move to the right, you see less and less of his lower back because his elbows are moving backwards:

But we know from our anatomy pictures the biceps aren’t pulling the arm or elbow backwards. After all, the bicep connects on the front of the arm. So we know the person isn’t using their biceps to do this motion. They’re using the humeral extensors to pull the elbow back, which can end up placing the elbow in a position of flexion, making the subsequent elbow flexion motion easier on the biceps, since some of the work has already been done for it. You can flex your elbow without using the elbow flexors!

-> The guy leaned over some, did a bent over row to pull his arms back, which can be largely done just using something like the lats, then he stands up some with his already bent elbows, and completes the curl. It’s like doing a curl without ever using the biceps for the first third to half of the curl.

Lean over,

Pull your elbows back (humeral extension) and the elbows will end up being in a position of flexion:

Stand up straight and your elbows are now already a good deal through the curl motion:

Then curl, and you end up with less than a full curl exercise.

An easy way to make a bicep curl much harder on the biceps is to have someone curl while standing against a wall, and make sure if anything, that as they curl their elbows move forward, not backward:

We can also see the biceps is going to play a role with keeping humeral stability:

It can pull the humeral head towards the glenoid, meaning the biceps can play a role in keeping the humeral head snug in the socket. This is one reason baseball pitchers are notorious for having jacked up biceps tendons. They put their shoulder through extreme ranges of motion, which exerts pressure on the biceps tendon.

If you’re training baseball players, and training their biceps, you’ll probably want to pay some mind to how their humeral head and scapula operate during that time. Notice above how the top of the scapula is just above the biceps tendon. If that scapula tilts forward and downward, it’s more likely to impinge the bicep. (Pull ups or chin ups with anteriorly tilted shoulders -or doing those when you have kyphosis issues- can be a big no-no. Really, working the biceps from an overhead position (impingement issues more likely) in a population known for sensitive bicep tendons is something to be careful with no matter what. (Just go with an inverted row.))

When it comes to muscles and the shoulder joint, the rotator cuff is often all that’s talked about, but it’s pretty obvious the biceps play a role too.

Notice how advanced we’ve gotten largely from looking at a picture. You don’t need to remember anatomy like you’re memorizing a phone number, or read thousands of studies to grasp why and how something works. Sure, you should still do some follow up and make sure what you envision is correct and has some evidence behind it, but I find it’s a lot easier to do the envisioning first.

Overall what you want to distinguish is between understanding and implementing your knowledge of anatomy with merely memorizing it.

The above can help you grasp:

  • why someone may say they feel like bent over rows don’t really hit their biceps
    • their lats do all the work
  • why someone can have a lower back pump when doing a bicep exercise
    • they swing too much
  • shoulder pain when doing elbow flexion
    • their scapula or humeral head may be moving despite doing an elbow flexion exercise
    • the proximal biceps tendon is so sensitive, any intense contraction annoys it
  • shoulder pain when trying to stretch their bicep
    • a sensitive biceps tendon is pulling against the humeral head.
  • getting someone a more effective bicep workout with less weight
    • while sometimes people just want to look cool lifting more weight, and you ARE still going to get some solid bicep work even if doing a curl where you cheat 5 different ways, typically if you can accomplish the same goal with less weight, it’s wise to do so, as it becomes a safer exercise.

Whereas memorizing a list of anatomy facts won’t tell you all this.

Think of it as learning a language. You can memorize a bunch of English words in Spanish, but that’s a far cry from becoming fluent in Spanish.

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