Triceps Brachii Trigger Points
Introduction
The triceps brachii is a large arm muscle responsible for elbow extension, shoulder stability, and upper limb strength. When trigger points develop in this muscle, they can cause posterior arm pain, elbow stiffness, and grip weakness, often mimicking tennis elbow, nerve compression, or rotator cuff dysfunction.
Name and Area
Name: Triceps Brachii
Area: Located in the posterior upper arm, running from the scapula and humerus to the olecranon process of the ulna (elbow).
Indications
Triceps brachii trigger points may contribute to:
Pain in the Back of the Arm That Feels Like a Deep Ache (Mistaken for Tennis Elbow or Nerve Pain)
Pain That Radiates to the Elbow and Forearm (Can Mimic Radial Nerve Compression or Biceps Tendinitis)
Weakness in Pushing Movements (Difficulty with Push-Ups, Bench Press, or Extending the Arm Fully)
Pain or Fatigue in the Arm After Repetitive Overhead Activities (Common in Throwing Sports and Weightlifting)
Tightness in the Triceps That Limits Full Arm Extension
Pain That Worsens with Pressing or Extending the Arm Against Resistance
Pain from this muscle is often mistaken for tennis elbow, rotator cuff dysfunction, or radial nerve irritation.
Muscle Action
Extends the Elbow: Straightens the arm, essential for pushing and pressing movements.
Assists in Shoulder Stability: Supports the humerus during overhead activities.
Helps in Arm Adduction: Works with other upper limb muscles to control arm movement.
The triceps brachii is crucial for arm strength, upper body function, and shoulder support.
Signs and Symptoms
Individuals with triceps brachii trigger points often report:
Pain in the Back of the Arm and Elbow That Feels Like a "Burning" or "Tight" Sensation
Pain That Radiates to the Outer Forearm and Wrist (Can Mimic Tennis Elbow or Nerve Compression)
Weakness in Pushing Movements, Making It Harder to Perform Pressing Exercises or Extend the Arm Fully
Pain That Worsens with Repetitive Arm Movements (Throwing, Lifting, or Weight Training)
Stiffness in the Triceps That Limits Full Extension of the Elbow
Pain That Worsens with Overhead Pressing or Holding Objects at Shoulder Height
Pain worsens with repetitive arm extension, heavy lifting, or prolonged muscle use.
Perpetuating Factors
Common causes of triceps brachii trigger points include:
Overuse in Pushing Exercises (Bench Press, Push-Ups, Dips, or Overhead Pressing Movements)
Repetitive Overhead Throwing (Common in Baseball, Tennis, Volleyball, and Swimming)
Weak Shoulder Stabilizers (Can Force the Triceps to Overcompensate for Arm Stability)
Poor Lifting Mechanics (Can Lead to Overuse of the Triceps and Shoulder Dysfunction)
Prolonged Elbow Extension or Leaning on the Arm (Common in Cyclists, Computer Users, or Those Who Sleep with the Arm Extended)
Trigger Point Referral Pattern
Trigger points in the triceps brachii refer pain to:
The posterior upper arm and elbow (Can Mimic Tennis Elbow or Olecranon Bursitis)
The outer forearm and wrist (Mistaken for Radial Nerve Compression or Extensor Tendinitis)
The back of the shoulder (Can Resemble Rotator Cuff Dysfunction or Posterior Deltoid Pain)
Pain from this muscle is often confused with lateral epicondylitis, shoulder impingement, or nerve entrapment syndromes.
Differential Diagnosis
Triceps brachii trigger points may be mistaken for:
Tennis Elbow (Lateral Epicondylitis – Pain in the Outer Elbow, Worsens with Gripping and Wrist Movements)
Radial Nerve Entrapment (Pain and Numbness Along the Radial Nerve Path, Can Mimic Nerve Irritation)
Rotator Cuff Dysfunction (Shoulder Pain and Weakness, Often Affects Overhead Movements)
Olecranon Bursitis (Pain and Swelling at the Tip of the Elbow, Can Be Tender to Touch)
Triceps Tendinitis (Pain and Inflammation in the Triceps Tendon, Worsens with Arm Extension and Pressing Movements)
A thorough shoulder, arm, and elbow examination is necessary to rule out these conditions.
Associated Trigger Points
Triceps brachii trigger points often co-exist with:
Deltoid (Shoulder and Upper Arm Pain, Can Contribute to Shoulder Weakness and Instability)
Latissimus Dorsi (Shoulder and Upper Back Pain, Common in Overhead Athletes and Weightlifters)
Infraspinatus (Posterior Shoulder and Arm Pain, Affects Shoulder Stability and External Rotation)
Brachioradialis (Forearm and Wrist Pain, Can Mimic Nerve Compression or RSI)
Anatomy and Innervation
| Muscle | Origin | Insertion | Innervation |
|---|---|---|---|
| Triceps Brachii (Long Head) | Infraglenoid tubercle of scapula | Olecranon process of ulna | TRadial nerve (C6–C8) |
| Triceps Brachii (Lateral Head) | Posterior humerus (above radial groove) | Olecranon process of ulna | TRadial nerve (C6–C8) |
| Triceps Brachii (Medial Head) | Posterior humerus (below radial groove) | Olecranon process of ulna | TRadial nerve (C6–C8) |
The triceps brachii is innervated by the radial nerve (C6–C8), which also controls elbow extension, wrist function, and upper limb strength.
Patient Examination
A comprehensive examination should include:
Palpation: Identify tender nodules along the posterior upper arm, elbow, and forearm.
Resisted Elbow Extension Testing: Assess pain and weakness when straightening the arm against resistance.
Gait and Postural Analysis: Look for excessive shoulder strain, compensatory movement patterns, or overuse signs.
Grip Strength and Forearm Mobility Testing: Rule out nerve compression, wrist dysfunction, or extensor weakness.
Corrective Actions
Dry Needling
Dry needling can release trigger points in the triceps brachii, reducing upper arm tightness and improving elbow function.
Manual Therapy
Trigger Point Release: Apply deep sustained pressure to tight spots in the posterior arm and elbow.
Massage Therapy: Helps improve circulation and reduce muscle tension in the triceps.
Stretching
Overhead Triceps Stretch: Helps lengthen the triceps and improve shoulder mobility.
Cross-Body Arm Stretch: Loosens the posterior shoulder and arm muscles.
Strengthening Exercises
Triceps Dips: Strengthens the triceps and improves pushing strength.
Resistance Band Triceps Extensions: Helps develop endurance in the posterior arm muscles.
Single-Arm Overhead Extensions: Encourages triceps activation and reduces overcompensation by other muscles.
Postural and Movement Adjustments
Avoid Excessive Arm Overuse (Balance Upper Body Training to Prevent Triceps Overcompensation)
Ensure Proper Lifting and Pushing Mechanics (Prevents Unnecessary Triceps Strain)
Use Ergonomic Workstation Adjustments (Prevents Overuse of the Triceps in Desk Work and Repetitive Arm Movements)
Conclusion
The triceps brachii plays a crucial role in elbow extension, arm strength, and shoulder stability, but trigger points in this muscle can cause significant upper arm, elbow, and forearm pain. By incorporating dry needling, manual therapy, stretching, and strengthening exercises, individuals can reduce pain, improve mobility, and prevent triceps dysfunction.
➡️ Learn more about Trigger Points
➡️ Explore our Trigger Point Index
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.