Coracobrachialis Trigger Points

Introduction

The coracobrachialis is a small but important upper arm muscle that plays a key role in shoulder flexion and arm adduction. When trigger points develop in this muscle, they can cause pain in the front of the shoulder, upper arm, and forearm, often mimicking biceps tendinitis, rotator cuff injuries, or nerve entrapment syndromes.

Name and Area

  • Name: Coracobrachialis

  • Area: Located in the upper arm, running from the coracoid process of the scapula to the medial humerus.

Indications

Coracobrachialis trigger points may contribute to:

  • Pain in the Front of the Shoulder and Upper Arm

  • Pain That Travels Down to the Forearm and Wrist (Can Mimic Nerve Compression)

  • Weakness in Shoulder Flexion and Arm Adduction

  • Discomfort When Reaching Forward or Lifting the Arm

  • Pain When Carrying Objects With the Arm in Front of the Body

  • Tingling or Numbness in the Forearm (Often Mistaken for Thoracic Outlet Syndrome)

Pain is often mistaken for biceps tendinitis or nerve compression.

Muscle Action

  • Shoulder Flexion: Lifts the arm forward.

  • Arm Adduction: Brings the arm closer to the body’s midline.

  • Assists in Shoulder Stability: Works with the biceps brachii and pectoralis major.

The coracobrachialis is most active during pushing, reaching, and carrying movements.

Signs and Symptoms

Individuals with coracobrachialis trigger points often report:

  • Deep, Aching Pain in the Front of the Shoulder or Upper Arm

  • Pain That Travels to the Elbow or Forearm (Mimicking Nerve Pain)

  • Weakness When Lifting Objects Close to the Body

  • Pain When Reaching Forward (E.g., Driving, Reaching for a Shelf, Holding a Steering Wheel)

  • Tingling or Numbness Along the Inner Forearm (Similar to Thoracic Outlet Syndrome or Ulnar Nerve Compression)

Pain worsens with repetitive lifting, pushing, or carrying objects with an extended arm.

Perpetuating Factors

Common causes of coracobrachialis trigger points include:

  • Repetitive Overhead or Forward Reaching Movements (Weightlifting, Throwing, Boxing, Swimming)

  • Frequent Carrying of Heavy Bags (Groceries, Suitcases, or Baby Carriers)

  • Typing or Holding a Steering Wheel for Long Periods

  • Poor Shoulder Posture (Rounded Shoulders or Forward Head Position)

  • Compensation for Weak Rotator Cuff Muscles

Trigger Point Referral Pattern

Trigger points in the coracobrachialis refer pain to:

  • The front of the shoulder (Similar to Biceps Tendinitis)

  • The upper arm and forearm, extending toward the wrist

  • The inner elbow (Mimicking Ulnar Nerve Pain or Thoracic Outlet Syndrome)

Pain is often confused with rotator cuff injuries, nerve entrapment, or bicipital tendinitis.

Differential Diagnosis

Coracobrachialis trigger points may be mistaken for:

  • Bicipital Tendinitis (Pain in the Bicipital Groove and Shoulder Weakness)

  • Rotator Cuff Injuries (Pain With Overhead Movements, Shoulder Instability)

  • Thoracic Outlet Syndrome (Numbness and Tingling Down the Arm Due to Nerve Compression)

  • Cervical Radiculopathy (C6–C7 Nerve Root Compression Mimicking Shoulder and Arm Pain)

  • Medial Epicondylitis (Golfer’s Elbow – Pain Near the Inner Elbow, but Without Shoulder Involvement)

A thorough shoulder and arm assessment is crucial for correct diagnosis.

Associated Trigger Points

Coracobrachialis trigger points often co-exist with:

  • Biceps Brachii (Elbow and Shoulder Pain, Forearm Weakness)

  • Pectoralis Major (Pain in the Chest and Shoulder, Poor Shoulder Mobility)

  • Triceps Brachii (Elbow and Shoulder Pain, Difficulty Extending the Arm)

  • Anterior Deltoid (Pain With Forward Reaching and Shoulder Flexion Movements)

Anatomy and Innervation

The coracobrachialis is innervated by the musculocutaneous nerve, which also supplies the biceps brachii and brachialis.

Patient Examination

A comprehensive examination should include:

  • Palpation: Identify tender nodules along the inner upper arm and shoulder.

  • Resisted Shoulder Flexion Testing: Assess pain and weakness when lifting the arm against resistance.

  • Grip Strength Testing: Determine if pain affects endurance when holding objects for long periods.

  • Thoracic Outlet and Ulnar Nerve Testing: Rule out nerve compression syndromes.

Corrective Actions

Manual Therapy

  • Trigger Point Release: Apply firm pressure to the upper arm and coracoid area.

  • Myofascial Release: Stretch and mobilize surrounding shoulder and chest muscles.

Stretching

  • Chest and Shoulder Stretch: Extend the arm backward with the palm facing up to stretch the coracobrachialis and biceps.

  • Wall Stretch: Stand next to a wall, place the palm on the wall, and gently rotate away to stretch the front of the shoulder.

Strengthening Exercises

  • Eccentric Shoulder Flexion Drills: Helps strengthen the coracobrachialis while reducing muscle tightness.

  • Scapular Retraction Exercises: Improves shoulder posture and stability.

  • Grip Strength Drills: Enhances forearm endurance and function.

Postural and Ergonomic Adjustments

  • Modify Overhead Lifting Techniques (Reduce Strain on the Shoulder and Arm)

  • Improve Desk Ergonomics (Avoid Holding the Arm in a Fixed Position for Long Periods)

  • Use Proper Carrying Techniques to Reduce Shoulder Stress

Muscle Origin Insertion Innervation
Coracobrachialis Coracoid process of scapula Medial humerus (mid-shaft) Musculocutaneous nerve (C5–C7)
Field Details
Name & Area Coracobrachialis; Upper arm, spanning shoulder to humerus
Indications Shoulder and upper arm pain, forearm discomfort, grip weakness
Muscle Action Shoulder flexion, arm adduction, assists in shoulder stabilization
Signs & Symptoms Pain in the front of the shoulder, weakness in lifting, discomfort when carrying objects
Perpetuating Factors Repetitive overhead lifting, sustained forward reaching, poor shoulder posture, carrying heavy objects
Trigger Point Referral Anterior shoulder, upper arm, inner elbow, forearm
Differential Diagnosis Biceps tendinitis, rotator cuff injury, thoracic outlet syndrome, nerve entrapment
Associated Trigger Points Biceps brachii, pectoralis major, triceps brachii, anterior deltoid
Anatomy & Innervation Musculocutaneous nerve (C5–C7)
Corrective Actions Manual therapy, stretching, strengthening, ergonomic changes

Summary Table: Coracobrachialis Trigger Points

Sources:

  • Travell, J. G., & Simons, D. G. (1983). Myofascial Pain and Dysfunction: The Trigger Point Manual (2nd ed.). Williams & Wilkins.

  • Simons, D., & Travell, J. (1999). The Trigger Point Manual, Volume 2: The Lower Extremities. Williams & Wilkins.