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Supinator always acts together with biceps, except when the elbow joint is extended. [7] It is the most active muscle in forearm supination during unresisted supination, while biceps becomes increasingly active with heavy loading. [8] Supination strength decreases by 64% if supinator is disabled by, for example, injury. [9]
Some scientists believe the radial tunnel extends as far as the distal border of the supinator. The radial nerve is commonly compressed within a 5 cm region near the elbow, but it can be compressed anywhere along the forearm if the syndrome is caused by injury (e.g. a fracture that puts pressure on the radial nerve). [3]
The supinator and the anconeus are the two extensor muscles in the posterior compartment of the forearm that do not pass through wrist extensor compartments. [3] The first compartment locating the most radial is occupied by the extensor pollicis brevis and the abductor pollicis longus to insert to the thumb.
The biceps is a particularly powerful supinator of the forearm due to the distal attachment of the muscle at the radial tuberosity, on the opposite side of the bone from the supinator muscle. When flexed, the biceps effectively pulls the radius back into its neutral supinated position in concert with the supinator muscle. [14]: 346–347
The intrinsic muscles of the forearm act on the forearm, meaning, across the elbow joint and the proximal and distal radioulnar joints (resulting in pronation or supination), whereas the extrinsic muscles act upon the hand and wrist. In most cases, the extrinsic anterior muscles are flexors, while the extrinsic posterior muscles are extensors.
The posterior interosseous nerve (or dorsal interosseous nerve/deep radial nerve) is a nerve in the forearm. It is the continuation of the deep branch of the radial nerve, after this has crossed the supinator muscle. It is considerably diminished in size compared to the deep branch of the radial nerve.
Pronator teres syndrome is one cause of wrist pain. It is a type of neurogenic pain. Patients with the pronator teres syndrome have numbness in median nerve distribution with repetitive pronation/supination of the forearm, not flexion and extension of the elbow
The brachioradialis is a muscle of the forearm that flexes the forearm at the elbow. [1] [2] It is also capable of both pronation and supination, depending on the position of the forearm. [2] It is attached to the distal styloid process of the radius by way of the brachioradialis tendon, and to the lateral supracondylar ridge of the humerus.