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The trigger point referral patterns discussed here all create pain in the elbow from trigger points in the triceps muscle. Mostly, this pain occurs when you forcefully straighten the elbow. When they are chronic, they hurt all the time.
Many patients complain of “tennis elbow.” Therapeutically, it is called “lateral epicondylitis” and can come from trigger point referral of several different muscles. Usually, it comes from the supinator muscle and hurts during a twisting flick of the wrist. Each of these “tennis elbow” patterns is a little different.
People who don’t play tennis complain of other activities that straighten the elbow under resistance. Weight lifting, gardening, pressing out cookies, and bracing yourself on amusement rides are classic irritants.
This is one of the most common patterns of elbow pain. It produces pain that hurts at the elbow and creates vague pain up the back of the arm. This head of the triceps crosses the shoulder and elbow joint. So, it bothers people in activities that forcefully extend the elbow while drawing the arm back or down. This one is different from the other two because there is often vague pain along the back of the arm.
Sometimes, This trigger point hurts primarily at the shoulder. This is because those motions tend to happen when the shoulder is stretched overhead, like serving a tennis ball. I discuss that in this other post.
In tennis, this often hurts in a reaching backhand with a backspin. It can also be aggravated on service when the elbow snaps straight.
Patients who don’t play tennis aggravate these trigger points in other ways. Whipping the hose behind you while working in the yard irritates it. It bothers some people when tugging the covers while making the bed. Again, this involves straightening the elbow while moving the arm down or back.
This trigger point creates pain in pushing motions that straighten the elbow, like serving or a reaching backstroke. For players, it still seems to be “tennis elbow.” Other people create this pain with unusually vigorous activity in the yard or the house or on a physically challenging weekend outing.
When this is chronic, the outside of the elbow aches constantly. Often, it creates a trail of pain toward the thumb.
Unlike the previous trigger point, the shoulder and upper arm movements are less critical. This muscle is the meaty prime mover of the elbow. It secures the ulna instead of crossing over to the shoulder blade.
People activate this with repetitive, forceful, or jerky activities like digging in the yard. Also, weightlifting bench presses, shoulder presses, chopping nuts, and cutting cookies aggravate this muscle. Sometimes, forceful throwing does it too.
Sometimes, patients complain of pain right on the hard prominence of the elbow. Anatomically this is called the olecranon process. Patients are often concerned that they have bruised or strained the attachments on the elbow. They also express concerns about bumping the elbow or damaging the joint, and they don’t know how they did it.
This is a different trigger point in the same medial head of the triceps. It also hurts under a forceful extension of the elbow in the same sort of activities. On this one, like the previous trigger point, stabilizing the shoulder or extending the arm is not as important.
Take a look at the activities in the previous section. The same activities of repetitive, forceful, or jerky extension of the elbow aggravate this too. Digging. Chopping. Throwing. Dumbell Presses.
This post on anatomy contains standard information about the origin, insertion, function, and innervation of muscles. It also includes information on functional considerations and anomalies.
Anatomy posts have a grid of all related posts. This includes posts on pain patterns, self-care, therapy notes, NMT protocols, cranial techniques, and cases.
Self-Care Posts have common sections to make them easy to follow and understand:
Therapy Notes provide details for cranial, spinal, and local joint work. These notes also link to a traditional neuromuscular protocol.
By treating integrative components first, direct work on the muscle becomes less intense while providing longer-lasting relief.
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Tony Preston has a practice in Atlanta, Georgia, where he sees clients. He has written materials and instructed classes since the mid-90s. This includes anatomy, trigger points, cranial, and neuromuscular.
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*This site is undergoing significant changes. We are reformatting and expanding the posts to make them easier to read. The result will also be more accessible and include more patterns with better self-care. Meanwhile, there may be formatting, content presentation, and readability inconsistencies. Until we get older posts updated, please excuse our mess.
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